Cellulitis in Pediatric Patients: Recognition and Management in the Era of Evolving Resistance

Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016;316(3):325–37. https://doi.org/10.1001/jama.2016.8825.

Article  PubMed  Google Scholar 

Collier EK, Yang JJ, Sangar S, Chen ST, Huang JT, Bach DQ. Evaluation of emergency department utilization for dermatologic conditions in the pediatric population within the United States from 2009–2015. Pediatr Dermatol. 2021;38(2):449–54. https://doi.org/10.1111/pde.14476.

Article  PubMed  Google Scholar 

Cutler TS, Jannat-Khah DP, Kam B, Mages KC, Evans AT. Prevalence of misdiagnosis of cellulitis: a systematic review and meta-analysis. J Hosp Med. 2023;18(3):254–61. https://doi.org/10.1002/jhm.12977.

Article  PubMed  Google Scholar 

Nightingale R, Yadav K, Hamill L, et al. Misdiagnosis of uncomplicated cellulitis: a systematic review and meta-analysis. J Gen Intern Med. 2023;38(10):2396–404. https://doi.org/10.1007/s11606-023-08229-w.

Article  PubMed  PubMed Central  Google Scholar 

Weng QY, Raff AB, Cohen JM, et al. Costs and consequences associated with misdiagnosed lower extremity cellulitis. JAMA Dermatol. 2017;153(2):141–6. https://doi.org/10.1001/jamadermatol.2016.3816.

Article  PubMed  Google Scholar 

Biglione B, Cucka B, Chand S, et al. Distinguishing clinical features for pseudocellulitis in pediatric inpatients: a retrospective study. Pediatr Dermatol. 2022;39(4):570–3. https://doi.org/10.1111/pde.15014.

Article  PubMed  Google Scholar 

VisualDx. Cellulitis. Available from: https://www.visualdx.com/visualdx/diagnosis/cellulitis?diagnosisId=51263&moduleId=102. Accessed 2 Mar 2024.

Norazirah M, Khor I, Adawiyah J, Tamil A, Azmawati M. The risk factors of lower limb cellulitis: a case-control study in a tertiary centre. Malays Fam Physician. 2020;15(1):23–9.

CAS  PubMed  PubMed Central  Google Scholar 

Ren Z, Silverberg JI. Association of atopic dermatitis with bacterial, fungal, viral, and sexually transmitted skin infections. Dermatitis. 2020;31(2):157–64. https://doi.org/10.1097/DER.0000000000000526.

Article  PubMed  Google Scholar 

Peterson RA, Polgreen LA, Sewell DK, Polgreen PM. Warmer weather as a risk factor for cellulitis: a population-based investigation. Clin Infect Dis. 2017;65(7):1167–73.

Article  PubMed  PubMed Central  Google Scholar 

Uchida E, Saito S, Morita D, et al. Skin and soft tissue infections in adolescent chronic myeloid leukemia under dasatinib treatment. Pediatr Blood Cancer. 2022;69(8): e29714. https://doi.org/10.1002/pbc.29714.

Article  CAS  PubMed  Google Scholar 

Zarezadeh Mehrabadi A, Aghamohamadi N, Abolhassani H, Aghamohammadi A, Rezaei N, Yazdani R. Comprehensive assessment of skin disorders in patients with common variable immunodeficiency (CVID). J Clin Immunol. 2022;42(3):653–64. https://doi.org/10.1007/s10875-022-01211-x.

Article  PubMed  Google Scholar 

Quirke M, Ayoub F, McCabe A, et al. Risk factors for nonpurulent leg cellulitis: a systematic review and meta-analysis. Br J Dermatol. 2017;177(2):382–94. https://doi.org/10.1111/bjd.15186.

Article  CAS  PubMed  Google Scholar 

Gunderson CG, Martinello RA. A systematic review of bacteremias in cellulitis and erysipelas. J Infect. 2012;64(2):148–55. https://doi.org/10.1016/j.jinf.2011.11.004.

Article  PubMed  Google Scholar 

Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-52. https://doi.org/10.1093/cid/ciu296.

Article  PubMed  Google Scholar 

Long B, Gottlieb M. Diagnosis and management of cellulitis and abscess in the emergency department setting: an evidence-based review. J Emerg Med. 2022;62(1):16–27. https://doi.org/10.1016/j.jemermed.2021.09.015.

Article  PubMed  Google Scholar 

Lautz TB, Raval MV, Barsness KA. Increasing national burden of hospitalizations for skin and soft tissue infections in children. J Pediatr Surg. 2011;46(10):1935–41. https://doi.org/10.1016/j.jpedsurg.2011.05.008.

Article  PubMed  Google Scholar 

Shriner A, Wilkie L. Pediatric cellulitis: a red-hot concern. Pediatr Ann. 2017;46(7):e265–9. https://doi.org/10.3928/19382359-20170620-01.

Article  PubMed  Google Scholar 

Brindle RJ, Ijaz A, Davies P. Procalcitonin and cellulitis: correlation of procalcitonin blood levels with measurements of severity and outcome in patients with limb cellulitis. Biomarkers. 2019;24(2):127–30. https://doi.org/10.1080/1354750X.2018.1501764.

Article  CAS  PubMed  Google Scholar 

Ko LN, Garza-Mayers AC, St John J, et al. Clinical usefulness of imaging and blood cultures in cellulitis evaluation. JAMA Intern Med. 2018;178(7):994–6. https://doi.org/10.1001/jamainternmed.2018.0625.

Article  PubMed  PubMed Central  Google Scholar 

Harper BD, Marcus CH, Burke N, Kawai K, Mansbach JM. Utility of inflammatory markers in hospitalized children with skin erythema. Hosp Pediatr. 2021;11(6):627–31. https://doi.org/10.1542/hpeds.2021-005825.

Article  PubMed  Google Scholar 

Noh SH, Park SD, Kim EJ. Serum procalcitonin level reflects the severity of cellulitis. Ann Dermatol. 2016;28(6):704–10. https://doi.org/10.5021/ad.2016.28.6.704.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Duvanel T, Auckenthaler R, Rohner P, Harms M, Saurat JH. Quantitative cultures of biopsy specimens from cutaneous cellulitis. Arch Intern Med. 1989;149(2):293–6.

Article  CAS  PubMed  Google Scholar 

Trenchs V, Hernandez-Bou S, Bianchi C, Arnan M, Gene A, Luaces C. Blood cultures are not useful in the evaluation of children with uncomplicated superficial skin and soft tissue infections. Pediatr Infect Dis J. 2015;34(9):924–7. https://doi.org/10.1097/INF.0000000000000768.

Article  PubMed  Google Scholar 

Bauer S, Aubert CE, Richli M, Chuard C. Blood cultures in the evaluation of uncomplicated cellulitis. Eur J Intern Med. 2016;36:50–6. https://doi.org/10.1016/j.ejim.2016.07.029.

Article  PubMed  Google Scholar 

Malone JR, Durica SR, Thompson DM, Bogie A, Naifeh M. Blood cultures in the evaluation of uncomplicated skin and soft tissue infections. Pediatrics. 2013;132(3):454–9. https://doi.org/10.1542/peds.2013-1384.

Article  PubMed  Google Scholar 

Patel Wylie F, Kaplan SL, Mason EO, Allen CH. Needle aspiration for the etiologic diagnosis of children with cellulitis in the era of community-acquired methicillin-resistant Staphylococcus aureus. Clin Pediatr (Phila). 2011;50(6):503–7. https://doi.org/10.1177/0009922810394652.

Article  PubMed  Google Scholar 

Piso RJ, Pop R, Wieland M, et al. Low sensitivity of needle aspiration cultures in patients with cellulitis/erysipelas. Springerplus. 2016;5(1):1578. https://doi.org/10.1186/s40064-016-3293-z.

Article  PubMed  PubMed Central  Google Scholar 

Crisp JG, Takhar SS, Moran GJ, et al. Inability of polymerase chain reaction, pyrosequencing, and culture of infected and uninfected site skin biopsy specimens to identify the cause of cellulitis. Clin Infect Dis. 2015;61(11):1679–87.

Article  CAS  PubMed  Google Scholar 

Toleman MS, Vipond IB, Brindle R. Specific PCR, bacterial culture, serology and pharyngeal sampling to enhance the aetiological diagnosis of cellulitis. J Med Microbiol. 2016;65(1):44–7. https://doi.org/10.1099/jmm.0.000191.

Article  CAS  PubMed  Google Scholar 

Kielhofner MA, Brown B, Dall L. Influence of underlying disease process on the utility of cellulitis needle aspirates. Arch Intern Med. 1988;148:2451–2.

Article  CAS  PubMed  Goog

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