Hemophilus influenzae type B buccal cellulitis

During a 10-year period there were seventy-two cases of buccal cellulitis caused by Hemophilus influenzae type b (HIb). Patients ranged in age from 3 months to 3 years; 72% were less than 2 year of age. Most children had a poorly demarcated, violaceous discoloration of one cheek. Sixty-eight percent of patients had an associated otitis media, and HIb was isolated from middle ear aspirates of twenty-two of twenty-three children. Bacteremia was present in 86% of patients, and five (7.6%) had associated meningitis. Ampicillin, chloramphenicol, cephamandole, or a combination of ampicillin and chloramphenicol, all proved effective for therapy of this condition. The duration of fever was more prolonged after cephamandole or ampicillin than after a combination of ampicillin and chloramphenicol or chloramphenicol alone. Recommendations for diagnosis and treatment are made.