Cellulitis In Children: Signs, Causes, Diagnosis & Treatment

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Cellulitis in children is more prevalent, especially in those with compromised immune systems and other skin conditions (1). However, it can occur at any age. Cellulitis is an inflammatory skin infection caused by Staphylococcus or Streptococcus bacteria. It usually affects the upper skin layer, leading to inflammation and blister formation. It may spread to deep skin layers in severe cases and result in complications. In most cases, a child recovers within seven to ten days of antibiotic treatment.

Read this post to know more about the symptoms, signs, diagnosis, treatment, and prevention of cellulitis in children.

Symptoms Of Cellulitis In Children

Cellulitis most commonly occurs in the lower legs. However, it can affect any body part. For instance, when cellulitis affects the skin around the eye, it’s called periorbital cellulitis. Below are some of the common symptoms that a child may experience (1) (2).

  • Swollen, hot, and painful skin
  • Red and bruised skin with blisters
  • Swollen lymph glands (nodes) near the affected skin
  • Swollen lymph vessels, appearing as red streaks on the skin
  • Fever and chills
  • Rapid heart rate
  • Low blood pressure

The intensity and duration of symptoms may vary from one child to another. These symptoms could also occur due to other problems. Therefore, consult a healthcare provider for a diagnosis.

Causes Of Cellulitis In Children

Cellulitis commonly occurs due to bacterial infection of a wound or an area that hasn’t healed. The most common bacterial strains that cause the infection are (1) (2) (3):

  • Group A beta-hemolytic streptococcus
  • Streptococcus pyogenes
  • Staphylococcus aureus, including methicillin-resistant staphylococcus aureus (MRSA)

A child is at risk of cellulitis when they have any of the following (1).

  • Skin injury: A minor cut, bruise, injury, or animal bite can expose the skin to bacteria, increasing the risk of bacterial infection.
  • Skin inflammation: Inflamed skin is vulnerable to bacterial infection. A child may have skin inflammation due to eczema or radiation therapy.
  • Skin infection: Certain skin infections, such as impetigo and ringworm (tinea), can cause itching, exposing the skin to secondary bacterial infections, such as cellulitis.
  • Weakened immunity: Children on cancer medication and those born with health conditions that weaken immunity could be vulnerable to bacterial infections.

Diagnosis Of Cellulitis In Children

The doctor will take a note of the child’s symptoms and their medical history. In some cases, the doctor may take the sample of infected skin (biopsy) or do blood tests or culture to confirm the diagnosis and determine the bacteria type present (1) (2).

Treatment For Cellulitis In Children

The treatment for cellulitis depends on the child’s age, the severity of symptoms, and overall health. In cases with mild cellulitis, the doctor will prescribe oral antibiotic therapy to kill the bacteria and treat the infection. If the affected site has pus, the doctor will likely drain it to relieve pain and prevent infection spread.

The child is hospitalized and given intravenous antibiotics if oral antibiotics do not work. The child could also require hospitalization if they have moderate to severe cellulitis symptoms with fever and chills. Along with the antibiotic treatment, the doctor will suggest you the following home care tips (4) (5).

  • Raise the child’s affected body parts, such as an arm or leg, and decrease the activity whenever possible.
  • Keep the affected area clean and dry. If it’s dirty, clean the area with salty water.
  • Administer anti-analgesics and antipyretics, such as paracetamol (acetaminophen), under medical guidance to relieve pain and fever.
  • Keep the affected area covered with a bandage to prevent itching and infection spread.
  • Trim your child’s nails and instruct them to wash their hands before and after touching the affected area.
  • Instruct your child to avoid sharing their towels and clothes with others.
  • Ask your child to take plenty of rest and consume a healthy diet with adequate water.

Following the antibiotic course and taking proper home care can help most children recover with minimal discomfort. However, if the treatment doesn’t happen on time, cellulitis may lead to adverse complications.

Complications Of Cellulitis In Children

Here are some complications that can be avoided by providing prompt medical care to your child (2).

  • Inflammation of the membranes around the brain and the spinal cord (meningitis)
  • Bacterial infection of a joint (septic arthritis)
  • Inflammation of the kidneys (glomerulonephritis)

Prevention Of Cellulitis In Children

Preventing cellulitis is possible if you observe the following measures (2).

  • Clean bruises, cuts, abrasions, or other injuries immediately with cold water or saline solution
  • Ensure your child doesn’t touch or scratch open wounds, cuts, or insect bites.
  • Trim your fingernails to prevent scratching of the wound, bruises, cuts, and insect bites.

Cellulitis may not spread if the affected skin is closed. However, if the skin is broken and oozes fluids, touching the affected part may cause the spread of the infection to healthy skin. Therefore, keep your child away from family members with skin infections to avoid the risk of developing cellulitis.

When To Call A Doctor

Proper home care and antibiotic treatment can help a child recover with relative ease. However, you should call a doctor right away if the (1) (4):

  • Skin infection spreads to a large area.
  • Skin appears severely inflamed and is too painful to touch.
  • Skin in and around the affected site has a tingling sensation or numbness.
  • Skin in and around the affected site turns black.
  • Skin infection appears around the eyes or ears.

Cellulitis is a bacterial skin infection of the topmost skin layer usually affected by open wounds, bruises, cuts, or insect bites. In most cases, the timely treatment causes the infection to heal within seven to ten days. However, in some cases, the infection may worsen, leading to adverse complications. Keeping the affected site covered and trimming the child’s nails can help prevent infection spread.

Key Pointers

  • Cellulitis manifests as swollen skin, blisters, fever, or increased heart rate.
  • It may also result from an underlying condition such as eczema or compromised immunity.
  • Questionnaires, blood tests, and lab tests are some of the ways to diagnose the condition.
  • Delay in the treatment may lead to meningitis or septic arthritis complications.


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Swati Patwal

Swati Patwal is a clinical nutritionist and toddler mom with over eight years of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children. Then she worked as a nutrition faculty and clinical nutrition coach in different organizations. Her interest in scientific writing... more