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Definition
- A bacterial infection of the skin
- Main symptom is spreading redness that is painful to the touch
Health Information
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.
Care Advice
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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.
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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.
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Pain:
- For pain, give acetaminophen every 4 hours OR ibuprofen every 6 hours. Use as needed.
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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.
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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.
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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.
Call Your Doctor 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
Author: Barton Schmitt MD, FAAP
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