A rapidly spreading painful rash called cellulitis

Cellulitis is a deep-seated skin infection caused by bacteria such as streptococcus or staphylococcus, which are common bacteria found on the skin. However, when there is a breach in the skin, these bacteria invade the skin causing an infection that involve the skin or deeper structures. Cellulitis can occur anywhere on the body, but the most frequent location is the lower legs.

A child is at risk for cellulitis if he or she has:

✔️ A break in the skin from a fall, insect bite or burn
✔️ Underlying skin conditions like eczema or scabies
✔️ An embedded foreign body e.g. wood splinter

When should you suspect cellulitis in your child?

Initially, there may be a small area of skin involvement which is red, painful and warm. Sometimes, blisters may also appear on the skin. As the infection progresses, your child will start to develop a fever and appear ill. He or she may also refuse to move or resist touching the affected area. Usually, there would be noticeable swelling over the affected area as well.

Cellulitis

What should you do next?

Any child with suspected cellulitis needs to be seen by a doctor.

In mild cases of cellulitis, an oral antibiotic is usually prescribed, and improvement should be seen within the first 2-3 days of antibiotics.

Other home care advice includes:

📍 To always wash hands before and after touching the infected area. Cellulitis is usually not contagious. However, the bacteria can spread through an open wound to another person.

📍 Raise the affected area e.g. prop the leg on a pillow to help reduce the swelling

📍 Reduce discomfort from pain by serving paracetamol or ibuprofen according to the correct dose.

In severe cases of cellulitis, hospital admission is warranted as antibiotics need to be administered through the veins (IV) for a faster recovery. Severe cases rarely need surgery. However, if there is a collection of pus deep beneath the skin, doctors may need to open and drain the pus to allow better healing.

The key message for today is to never to disregard a rapidly spreading rash, especially if it is painful! 🙏

Reference:
1. Dr Amy Stanway : Cellulitis – https://dermnetz.org/topics/cellulitis/
2. Cellulitis in Children – Stanford Children’s Health www.stanfordchildrens.org/

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