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[Cellulitis in pediatrics. Diagnostic and therapeutic considerations]
Insights
This study on pediatric cellulitis found Staphylococcus aureus as a common cause, with enterobacteriaceae prevalent in younger children. Complications like osteoarthritis and sequelae were frequent, highlighting the need for timely diagnosis and treatment.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
Context:
- Cellulitis (phlegmona diffusa) is a common bacterial skin infection in children.
- This study analyzed 180 pediatric cases at a major medical center.
Purpose:
- To investigate the clinical characteristics, etiological agents, complications, and outcomes of pediatric cellulitis.
- To identify risk factors for complications and sequelae.
Summary:
- Staphylococcus aureus was the primary pathogen, with enterobacteriaceae found in 39% of patients under two years.
- One-third of cases experienced complications, including osteoarthritis in 14.4%.
- Lethality was 5%, linked to S. aureus septicemia. Osteoarticular complications often presented with prolonged fever and delayed antimicrobial treatment.
Impact:
- Highlights the significant morbidity associated with pediatric cellulitis, including long-term sequelae.
- Emphasizes the importance of early diagnosis and appropriate antibiotic management to prevent complications like osteoarthritis.
- Informs clinical practice regarding the timely identification and treatment of osteoarticular involvement in pediatric cellulitis.
Abstract:
The clinical histories of 180 cases of cellulitis or phlegmona diffusa were studied at the Hospital de Pediatría del Centro Medico Nacional. The disease prevailed in infants and preschool children. Staphylococcus aureus was the etiological agent most frequently found, but with the presence of enterobacteriaceae in 39% of patients under 2 years of age. One third of the children with cellulitis showed one or several complications. Lethality reached 5% (9 cases), but always related to septicemia from S. aureus. In 14.4%, osteoarthritis was present; frequently there was: fever for over 5 days in spite of adequate treatment, a history of late initiation of the antimicrobial drug (over 1 week) and phlogosis or functional limitation. The radiological picture that shows the bony lesion was evident only after two weeks. One half these cases remained with sequelae. Considerations are made on the adequate plans for antibiotic treatment and the early diagnosis of the osteoarticular complication.