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Published on: February 23, 2014

Cellulitis in childhood invasive pneumococcal disease: a population-based study

Jonathan B Gubbay1, Peter B McIntyre, Robin E Gilmour

  • 1National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|June 2, 2006
PubMed

Insights

Pneumococcal cellulitis in children is uncommon, primarily affecting the face in those under two years old. This condition is often misdiagnosed initially and rarely involves meningitis or other serious complications.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Limited data exists on the age-specific incidence and clinical presentation of pneumococcal cellulitis in children.
  • Pneumococcal cellulitis is a rare manifestation of invasive pneumococcal disease (IPD).

Purpose of the Study:

  • To determine the age-specific incidence and clinical characteristics of pneumococcal cellulitis in children.
  • To compare pneumococcal cellulitis with other forms of IPD in pediatric patients.

Main Methods:

  • Retrospective review of cellulitis cases as a subset of prospectively collected IPD data.
  • Systematic review of published literature on pneumococcal cellulitis.
  • Analysis of prospective laboratory surveillance data from New South Wales, Australia (1997-2001).

Main Results:

  • Of 1067 pediatric IPD cases, 38 (3.3%) were cellulitis (32 periorbital, 6 buccal).
  • Cellulitis predominantly affected children under 2 years old (79%), with fewer underlying illnesses compared to other IPD types.
  • Initial misdiagnosis occurred in 34% of cases; meningitis was uncommon (1.9% in literature cases).

Conclusions:

  • Pneumococcal cellulitis is an infrequent but typically facial manifestation of IPD in children.
  • The condition is most common in infants and toddlers, rarely associated with meningitis or other complications.
  • Pneumococcal cellulitis is often not recognized upon initial medical assessment.
Abstract

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