Microbiology of infected hemangiomas in children

Bacterial infections are a common complication of hemangiomas in children. The objective of this study was to establish the aerobic and anaerobic microbiology of infected hemangiomas. A retrospective 8-year review of clinical and microbiology laboratory records from patients with secondarily infected hemangiomas was carried out. Specimens from infected sites were processed for the presence of aerobic and anaerobic bacteria. Bacterial growth was present in 32 of 38 specimens. Aerobic bacteria alone were recovered in 12 infected hemangiomas (37.5%), anaerobic bacteria alone in 8 (33%), and mixed aerobic and anaerobic flora in 12 (37.5%). A total of 80 isolates (47 aerobes and 33 anaerobes) were recovered, giving an average of 2.5 isolates per specimen (1.5 aerobes and 1.0 anaerobes). The highest number of isolates were recovered in infections of the perineum (3.7 per site) and the legs (2.8 per site). The predominant aerobic isolates were Staphylococcus aureus, group A beta-hemolytic streptococci, and Enterobacteriaceae. The predominant anaerobes were Peptostreptococcus sp., gram-negative bacilli, and Fusobacterium sp. Organisms that belong to the mucous membranes close to the lesions predominated in infections next to those membranes. The polymicrobial etiology of secondarily infected hemangiomas and the association of bacterial flora with the anatomic site of the lesions is thereby demonstrated.