Pediatric emergency medicine trisk 2375 2375
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Scenario
Etiologies
Facial cellulitis (buccal, S. aureus, GAS,
periorbital)
pneumococcus
Erysipelas
Predominantly GAS
Odontogenic
Usually polymicrobial:
viridans group
streptococci,
Prevotella,
Fusobacterium
Cellulitis in patients
with lymphedema
GAS most common, S.
aureus
Trunk or extremities
Perineal
Perianal cellulitis
S. aureus, GAS
Often polymicrobial: S.
aureus, GAS, enteric
GNRs, Bacteroides
and other anaerobes
GAS
Cellulitis after water
exposure
S. aureus, GAS, Vibrio
vulnificus,
Comments
Hib cellulitis rare in
vaccinated children
Raised, beefy red, very
well-demarcated
borders; most common
on the legs; if see
involvement of the ear
(Milian ear sign), likely
erysipelas
Abscess drainage
essential; one
complication can be
Ludwig angina, a
rapidly progressive
cellulitis of the floor of
the mouth that can
result in airway
obstruction
Some patients may benefit
from oral PCN VK
prophylaxis if have
recurrent episodes
Over 70% are S. aureus
One risk factor in
adolescents is shaving
the genital area
Rapid strep swabs, while
not licensed outside the
nasopharynx, can help
guide initial therapy
Vibrio causes rapidly
progressive cellulitis
with bullae formation
