Cellulitis

Cellulitis simply means an infection of the skin. Your skin is your first barrier against germs and bacteria. When your skin is damaged (whether it be by cut, scrape, sore, etc.) bacteria has a chance to move in. Most bacteria thrive in a warm, wet environment so wounds are the ideal place to set up camp.

If left untreated, this infection can spread to other parts of the body and result in severe injury or death. It is also possible to develop cellulitis without an obvious break in the skin if a person has a weak immune system or other condition, such as diabetes, eczema or fungal infection, that compromises their ability to heal.

Causes of Cellulitis

The most common cause of cellulitis is bacteria like streptococcus (strep) or staphylococcus (staph). You may be wondering where these bacteria come from. They are actually all around us living, growing and thriving. Some of them we even consider “normal flora” which means they are commonly found on our own skin. Knowing this, it is remarkable that every cut we suffer doesn’t turn into cellulitis. It occurs more often in people with frequent exposure to meats, fish, chicken and soil as these items are a great breeding ground for bacteria.

Signs/Symptoms

Cellulitis can develop on any part of the body, however, in children it is most often seen on the face or around the anus.

Cellulitis usually presents as a warm/hot, red, swollen area that is tender to the touch. The redness may spread over time and the child may develop fever and chills. Swelling can be seen, not just in the immediate area, but in tissues around the site and result in severe pain/stiffness.

What to do if you suspect your child has cellulitis:

It is important to see your doctor right away if the infection is located on the face or the groin. Infections of the face can lead to serious complications including permanent blindness and damage to the brain. All forms of cellulitis can lead to an infection of the blood called sepsis which can be difficult to reverse and lead to other permanent injury or death.

If your child presents you with what appears to be an insect bite or sting but develops fever and chills, seek medical attention from a trained professional.

Lastly, even if you have already seen your doctor and been treated but are noticing worsening symptoms such as the infected area is growing instead of shrinking, it is becoming more painful, it has developed red streaks, or it has begun to discharge fluid, an immediate follow-up visit is warranted.

If you are experiencing any of the above and are unable to get in to see your pediatrician, do not hesitate. Remember, you can always take your child to an urgent care/ER and be seen and evaluated. Early diagnosis is important for proper treatment to prevent further complications.

Diagnosis/Tests

Determining the cause of your child’s condition will involve a physical exam where your Doctor looks at the site and asks you several questions about it. If fluid or drainage is visible, your doctor may take a sample to help identify what is growing in the wound. This is called a “culture” and will help her/him decide which antibiotic is best to treat the wound.

Managing Cellulitis

Don’t be surprised if treatment is begun before the results return. This is often done because of the severity of the diagnosis. Today physicians are apt to use what they call “broad spectrum” antibiotics. As the name implies, these antibiotics work on multiple different types of bacteria and are often the best treatment for the most common cellulitis associated infection. If a culture is done and it is determined that another antibiotic would better treat your child’s infection, you can expect the antibiotic to be changed.

The type of treatment is also dependent on how severe the infection is. For a mild infection, your doctor may feel comfortable treating your child with medications taken by mouth and sending you home.

In the case of more severe infection, expect to be admitted to a hospital for IV (in the vein) antibiotics and monitoring by trained professionals. A course of IV antibiotic can last from several days to several weeks so be prepared. It can also be extended if the infection does not respond well to the initial treatment or if other complications arise.

Whether your doctor chooses to treat your child by oral or IV antibiotics it is very important to remember to give the antibiotic EXACTLY AS IT IS PRESCRIBED. Do not stop the antibiotic early even if the wound looks much better than it did or resolves completely. Not finishing your antibiotic can cause the infection to return STRONGER than before and be RESISTANT to that antibiotic and antibiotics similar to it.