Cellulitis in Child
See also in: Cellulitis DDx,Anogenital,Hair and Scalp,Oral Mucosal LesionAlerts and Notices
Synopsis

In cellulitis, bacteria invade through breaks in the skin including puncture wounds, dermatitis, and burns. Implantable cardiac devices can also cause infection. The clinical manifestations include rapidly progressive areas of skin edema, redness, heat, and pain with or without associated lymphangitis or lymphadenitis. Systemic symptoms of fever, malaise, and chills are common. In immunosuppressed individuals, the infection can spread to cause large abscesses, necrosis, and dissemination into blood. Predisposing factors include conditions that compromise the barrier function of the skin or weaken host defenses such as obesity, trauma, or chronic edema.
Although many cases of cellulitis are attributable to streptococci, it is important to be cognizant of the rising prevalence of methicillin-resistant S. aureus (MRSA). MRSA should be considered for purulent infections. In the outpatient setting, MRSA coverage should be added for nonresponse to beta-lactam therapy. For pediatric inpatients with cellulitis, guidelines suggest community acquired MRSA (CA-MRSA) coverage.
Related topics: Orbital Cellulitis, Preseptal Cellulitis
Codes
ICD10CM:L03.90 – Cellulitis, unspecified
SNOMEDCT:
128045006 – Cellulitis
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
Deep tissue infection- Myonecrosis (gas gangrene)
- Necrotizing fasciitis
- Arthropod bite (insect, spider)
- Perianal streptococcal dermatitis
- Impetigo, bullous impetigo
- Herpes zoster
- Erythema migrans of Lyme disease
- Erysipelas (bright red, well-demarcated, systemically unwell)
- Staphylococcal scalded skin syndrome
- Wells syndrome (eosinophilic cellulitis)
- Atopic dermatitis
- Contact dermatitis (allergic, irritant)
- Phytophotodermatitis
- Sweet syndrome
- Erythema nodosum
Other
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:12/06/2016
Last Updated:05/20/2019
Last Updated:05/20/2019