title: Facial cellulitis in childhood: a changing spectrum.
abstract: BACKGROUND
  Before conjugated Haemophilus influenzae type b (Hib) vaccination, a syndrome known as buccal cellulitis, usually caused by Hib and often accompanied by bacteremia, was seen. We investigated the incidence and cause of facial cellulitis at our hospital during the 10 years before and the 10 years after introduction of the vaccine.
  
  
  METHODS
  Records of patients discharged with a diagnosis of facial cellulitis or infections of the oral cavity were reviewed. Fisher's exact test was used to compare rates of cellulitis during the two decades.
  
  
  RESULTS
  Trauma was the most common antecedent to facial cellulitis in both eras. Buccal cellulitis accounted for 7/25 (28%) of cases before Hib vaccination and 0/19 cases since. Pneumococcal buccal cellulitis was not seen in either decade.
  
  
  CONCLUSIONS
  Buccal cellulitis due to Hib is a disappearing disease. Eighty-nine percent of recent inpatient cases of childhood facial cellulitis were related to trauma, tooth problems, or severe sinusitis. Facial cellulitis due to S pneumoniae is rare.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
authors.forename: Randall G
authors.initials: RG
authors.lastname: Fisher
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Benjamin
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016667:Bacterial Capsules; D002481:Cellulitis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005148:Facial Dermatoses / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000627:therapeutic use; D019741:Haemophilus influenzae type b; D006801:Humans; D015994:Incidence; D007223:Infant; D011135:Polysaccharides, Bacterial / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
chemical_list: D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D011135:Polysaccharides, Bacterial