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Buccal cellulitis

J S Walker1, K J Corcoran

  • 1Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City 73126.

The American Journal of Emergency Medicine
|November 1, 1990
PubMed

Insights

Buccal cellulitis (BC) in infants often indicates bacteremia, particularly with Hemophilus influenzae, presenting as cheek infection. Prompt diagnosis and parenteral antibiotics are crucial, with lumbar puncture recommended for at-risk children due to potential meningitis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Bacteriology

Background:

  • Buccal cellulitis (BC) is a common cheek infection in children.
  • It frequently occurs with concurrent bacteremia, especially in infants under 12 months.
  • A short prodrome of coryza and fever often precedes BC onset.

Observation:

  • A purplish discoloration of the affected cheek suggests Hemophilus influenzae bacteremia.
  • Meningitis can be present even without typical meningeal signs.
  • Complete blood count, blood culture, and aspirate culture are essential diagnostic tools.

Findings:

  • The vast majority of children with BC are bacteremic.
  • Parenteral antibiotic treatment is typically required.
  • Lumbar puncture is indicated for children at risk for bacteremic BC to rule out meningitis.

Implications:

  • Early recognition and management of BC are vital to prevent serious complications.
  • Diagnostic protocols should include evaluation for bacteremia and meningitis.
  • Understanding BC's association with bacteremia guides appropriate pediatric infectious disease management.

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