Springdale Mason Pediatrics

Cellulitis

Definition

  • A bacterial infection of the skin
  • Main symptom is spreading redness that is painful to the touch

Call or Return If

  • Redness spreads after 2 days on antibiotic
  • Pain gets worse after 2 days on antibiotic
  • Fever lasts over 2 days on antibiotic
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • The main symptom is the sudden onset of spreading redness.
  • The borders of the redness are not sharp.
  • The redness is very painful and tender to touch.
  • Mild skin swelling in the infected area.
  • Sometimes, red streaks move up the arm or leg from the infection site. This is a bad sign.
  • Fever is only present 10% of the time.

Causes

  • Skin Wounds. Most often, a break in the skin is the entry for germs that cause this. Skin breaks can be from puncture wounds, cuts, scratches, or bites.
  • Skin rashes. Itchy rashes can cause scratch marks. Any break in the skin can get infected. Some itchy rashes are eczema, chickenpox, scabies, insect bites and poison ivy.
  • Cellulitis of the eyelids can be from a sinus infection.
  • Cellulitis of the cheek can be from a tooth abscess.
  • Staph and Strep are the most common bacteria that cause this.

Allergic Reactions: How to Know It's Not Cellulitis

  • Cellulitis can be confused with local skin allergic reactions because they look alike. They both have spreading redness. Bee stings cause the most confusion.
  • But cellulitis is painful, not itchy.
  • And local skin allergic reactions (as to insect bites) are itchy, not painful.

After Care Advice

Overview:
  • Cellulitis of the skin needs an antibiotic to stop the spread.
  • The drug can get into the deeper tissues.
  • An antibiotic by mouth given at home usually works.
  • Severe cellulitis may need meds given through a vein. For these cases, children are often in the hospital.
  • Here is some care advice that should help.
Antibiotic by Mouth:
  • Cellulitis needs a prescription for an antibiotic.
  • The drug will kill the bacteria that are causing the infection.
  • Give the drug as directed.
  • Try not to forget any of the doses.
Pain:
  • For pain, give acetaminophen every 4 hours OR ibuprofen every 6 hours. Use as needed.
Fever:
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
What to Expect:
  • After 24 hours on antibiotic: Symptoms will stop getting worse. Redness will stop spreading.
  • After 48 hours (2 days): Any fever should be gone. The site may look the SAME (not improved).
  • After 72 hours (3 days): Redness and pain at the site should start to be better. Your child should also feel better.
  • After treatment is done: The site should no longer be red or tender. Your child should feel back to normal.
Return to School:
  • Your child can go back to school after the fever is gone.
  • Your child should also feel well enough to join in normal activities.
  • Cellulitis has a very low risk of spread to others. Reason: there is no drainage.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2509