Buccal cellulitis.
Buccal cellulitis (BC) is an innocuous appearing infection of the cheek that is found in children and has a high incidence of concomitant bacteremia. Typically, the child is younger than 12 months and has a 2 to 8 hour prodrome of coryza and fever before developing the cellulitis on the cheek. A purplish hue on the cellulitic region is highly suggestive of Hemophilus influenzae bacteremia. The differential diagnosis is reviewed. A complete blood count, blood culture, and cellulitis aspirate culture, should be obtained on all patients with BC. Meningitis may be present despite the lack of meningeal signs. A lumbar puncture should be performed on all children at risk for bacteremic BC. The vast majority of these children are bacteremic and require parenteral antibiotics. A typical case of BC is presented and its management is reviewed.
Walker
J S
JS
Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City 73126.
Corcoran
K J
KJ
D000658:Amoxicillin / Q000008:administration & dosage; D002444:Cefuroxime / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D002610:Cheek; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006192:Haemophilus Infections / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D065093:beta-Lactamase Inhibitors
D002969:Clavulanic Acids; D065093:beta-Lactamase Inhibitors; D019818:Clavulanic Acid; D000658:Amoxicillin; D002444:Cefuroxime