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Cellulitis

Cellulitis is an infection of the skin and underlying tissues that can affect any area of the body. It often begins in an area of broken skin, like a cut or scratch. Then bacteria invade and spread, causing inflammation, pain, swelling, warmth, and redness.

Causes

Conditions that create breaks in the skin and allow bacteria to enter, such as eczema and severe acne, will put a child at risk for . Chickenpox, scratched insect bites, animal bites, and puncture wounds are other causes.

Cellulitis also can form in areas of intact skin, especially in people who have diabetes or who are taking medicines that suppress the immune system.

Orbital cellulitis, which infects the eyelid and tissues surrounding the eye, requires particularly close monitoring. It can be caused by minor trauma to the area around the eye (such as an insect bite or a scratch) or be an extension of another infection, such as sinusitis. This kind of cellulitis is treated with antibiotics and close follow-up. If untreated, it can progress to a more serious infection that affects vision.

Symptoms

Cellulitis IllustrationCellulitis, which is not contagious, usually begins as a small, inflamed area of pain, swelling, warmth, and redness on the skin. As this red area begins to spread, the child may begin to feel sick and develop a fever, sometimes with chills and sweats. Swollen lymph nodes (commonly called swollen glands) are sometimes found near the area of infected skin.

Prevention

You can prevent cellulitis by protecting your child's skin from cuts, bruises, and scrapes. This may not be easy, especially with active kids who love to explore or play sports. Protective equipment worn to prevent other injuries also can protect skin, such as elbow and knee pads for skating, a helmet for bike riding, shin guards for soccer, long pants and long-sleeved shirts for hiking in the woods, sandals (not bare feet) on the beach, and seatbelts while riding in a motor vehicle.

If your child does get a scrape, wash the wound well with soap and water. Apply an antibiotic ointment and cover the wound with an adhesive bandage or gauze. Contact your doctor if your child has a large cut, deep puncture wound, or bite (animal or human).

Diagnosis

The incubation period for cellulitis varies, depending on the type of bacteria causing it. Your doctor can diagnose cellulitis by asking a few questions and examining the area of affected skin.

Sometimes, especially in younger kids, a blood culture may be done to check for bacteria growth. A positive blood culture means that bacteria from the skin infection have spread into the bloodstream, a condition known as bacteremia. This can potentially lead to septicemia, an infection affecting many systems of the body.

Treatment

A child with severe cellulitis may be treated in the hospital using intravenous (IV) antibiotics. Kids with milder cellulitis can be treated at home with antibiotics. The doctor also may recommend keeping the affected part of the body immobilized and elevated to reduce swelling and pain. Pain relievers such as acetaminophen or ibuprofen can help reduce discomfort.

After 1 or 2 days on antibiotics at home, a child will return to see the doctor, who'll check to see that the area of cellulitis has improved and that the antibiotics are working to heal the infection.

When to Call the Doctor

Call the doctor whenever any area of your child's skin becomes red, warm, and painful — with or without fever and chills. This is especially important if the affected skin is on the face or if your child has a chronic illness (like diabetes) or a condition that suppresses the immune system.

Because cellulitis can happen very quickly after an animal bite, call the doctor if your child is bitten by an animal, especially if the puncture wound is deep. Human bites also can cause skin infections and should be seen by a doctor. If red streaks develop from the infected area or symptoms worsen despite antibiotic treatment, your child should be re-examined.

Reviewed by: Catherine L. Lamprecht, MD
Date reviewed: October 2013