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Buccal Cellulitis Reevaluated

Buccal Cellulitis Reevaluated Abstract • We studied 72 children (17 prospectively) with acute buccal cellulitis. The median age was 11 months. Fifty-five percent of patients were bacteremic, and three children without meningeal signs or symptoms had concomitant meningitis. Cellulitis aspirate cultures (eight of 35 positive) and urine bacterial antigen tests (13 of 27 positive) were useful in making an etiologic diagnosis. Infections due to other bacteria were clinically indistinguishable from those due to Haemophilus influenzae type b. The right cheek was affected more often than the left, and only 23 (32%) of 72 patients had otitis media ipsilateral to the involved cheek. The pathogenesis of buccal cellulitis likely involves direct mucous membrane invasion rather than spread from the ipsilateral middle ear. (AJDC 1986;140:891-893) References 1. Alexander H: Influenza bacillus infections , in Holt LE Jr, McIntosh R (eds): Pediatrics . East Norwalk, Conn, Appleton-Century-Crofts, 1953, p 1200. 2. Feingold M, Gellis SS: Cellulitis due to Haemophilus influenzae type b . N Engl J Med 1965;272:788-789Crossref 3. Rapkin RH, Bautista G: Haemophilus influenzae cellulitis . AJDC 1972;124:540-542. 4. Goetz JP, Tafari N, Boxerbaum B: Needle aspiration in Hemophilus influenzae type b cellulitis . Pediatrics 1974;54:504-506. 5. Bada H, Wright SP: Hemophilus influenzae cellulitis . Clin Pediatr 1974;13:658-660.Crossref 6. Granoff DM, Nankervis GA: Cellulitis due to Haemophilus influenzae type b . AJDC 1976; 130:1211-1214. 7. Nelson JD, Ginsburg CM: An hypothesis on the pathogenesis of Hemophilus influenzae buccal cellulitis . J Pediatr 1976;88:709-710.Crossref 8. Landwirth J: Bilateral cellulitis of cheeks in an infant due to Hemophilus influenzae . Clin Pediatr 1977;16:182-184.Crossref 9. Siddiqi WH, Reed TD: Hemophilus influenzae buccal cellulitis: Five cases in eight weeks . J Pediatr 1977;91:687-688.Crossref 10. Bosley ARJ, Murphy JF, Dodge JA: Systemic Haemophilus influenzae and facial cellulitis in infants . Br Med J 1981;282:22-23.Crossref 11. Carter S, Feldman WE: Etiology and treatment of facial cellulitis in pediatric patients . Pediatr Infect Dis 1983;2:222-224.Crossref 12. Granoff DM, Squires JE: Hemophilus meningitis: New developments in epidemiology, treatment and prophylaxis . Semin Neurol 1982; 2:151-165.Crossref 13. Todd JK, Bruhn FW: Severe Haemophilus influenzae infections . AJDC 1975;129:607-611. 14. Ginsburg CM: Buccal cellulitis . Pediatr Infect Dis 1983;2:381-382.Crossref 15. Melish ME: Bacterial skin infections , in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Disease . Philadelphia, WB Saunders Co, 1981, p 658. 16. Lennette EH, Spaulding EH, Truant JP (eds): Manual of Clinical Microbiology , ed 2. Washington, DC, American Society for Microbiology, 1974. 17. Rubin L, Moxon ER: Pathogenesis of bloodstream invasion with Haemophilus influenzae, type b . Infect Immun 1983;41:280-284. 18. Feigin RD: Bacterial meningitis beyond the neonatal period , in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Disease . Philadelphia, WB Saunders Co, 1981, pp 293-308. 19. Rotbart HA, Globe MP: Haemophilus influenzae type b septic arthritis in children: Report of 23 cases . Pediatrics 1985;75:254-259. 20. Thirumoorthi MC, Asmar BI, Dajani AS: Violaceous discoloration in pneumococcal cellulitis . Pediatrics 1978;62:492-493. 21. Lagergård T, Branefors P: Nature of cross-reactivity between Haemophilus influenzae types a and b and Streptococcus pneumoniae types 6A and 6B . Acta Pathol Microbiol Immunol Scand C 1983;91:371-376. 22. Murphy TV, Granoff D, Chrane DF, et al: Pharyngeal colonization with Haemophilus influenzae type b in children in a day care center without invasive disease . J Pediatr 1985;106:712-716.Crossref 23. Hampton CM, Barenkamp SJ, Granoff DM: Comparison of outer membrane protein subtypes of Haemophilus influenzae type b isolates from healthy children in the general population and from diseased patients . J Clin Microbiol 1983;18:596-600. 24. Todd JK: Bacteriology and clinical relevance of nasopharyngeal and oropharyngeal cultures . Pediatr Infect Dis 1984;3:159-163.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1986.02140230061033
Publisher site
See Article on Publisher Site

Abstract

Abstract • We studied 72 children (17 prospectively) with acute buccal cellulitis. The median age was 11 months. Fifty-five percent of patients were bacteremic, and three children without meningeal signs or symptoms had concomitant meningitis. Cellulitis aspirate cultures (eight of 35 positive) and urine bacterial antigen tests (13 of 27 positive) were useful in making an etiologic diagnosis. Infections due to other bacteria were clinically indistinguishable from those due to Haemophilus influenzae type b. The right cheek was affected more often than the left, and only 23 (32%) of 72 patients had otitis media ipsilateral to the involved cheek. The pathogenesis of buccal cellulitis likely involves direct mucous membrane invasion rather than spread from the ipsilateral middle ear. (AJDC 1986;140:891-893) References 1. Alexander H: Influenza bacillus infections , in Holt LE Jr, McIntosh R (eds): Pediatrics . East Norwalk, Conn, Appleton-Century-Crofts, 1953, p 1200. 2. Feingold M, Gellis SS: Cellulitis due to Haemophilus influenzae type b . N Engl J Med 1965;272:788-789Crossref 3. Rapkin RH, Bautista G: Haemophilus influenzae cellulitis . AJDC 1972;124:540-542. 4. Goetz JP, Tafari N, Boxerbaum B: Needle aspiration in Hemophilus influenzae type b cellulitis . Pediatrics 1974;54:504-506. 5. Bada H, Wright SP: Hemophilus influenzae cellulitis . Clin Pediatr 1974;13:658-660.Crossref 6. Granoff DM, Nankervis GA: Cellulitis due to Haemophilus influenzae type b . AJDC 1976; 130:1211-1214. 7. Nelson JD, Ginsburg CM: An hypothesis on the pathogenesis of Hemophilus influenzae buccal cellulitis . J Pediatr 1976;88:709-710.Crossref 8. Landwirth J: Bilateral cellulitis of cheeks in an infant due to Hemophilus influenzae . Clin Pediatr 1977;16:182-184.Crossref 9. Siddiqi WH, Reed TD: Hemophilus influenzae buccal cellulitis: Five cases in eight weeks . J Pediatr 1977;91:687-688.Crossref 10. Bosley ARJ, Murphy JF, Dodge JA: Systemic Haemophilus influenzae and facial cellulitis in infants . Br Med J 1981;282:22-23.Crossref 11. Carter S, Feldman WE: Etiology and treatment of facial cellulitis in pediatric patients . Pediatr Infect Dis 1983;2:222-224.Crossref 12. Granoff DM, Squires JE: Hemophilus meningitis: New developments in epidemiology, treatment and prophylaxis . Semin Neurol 1982; 2:151-165.Crossref 13. Todd JK, Bruhn FW: Severe Haemophilus influenzae infections . AJDC 1975;129:607-611. 14. Ginsburg CM: Buccal cellulitis . Pediatr Infect Dis 1983;2:381-382.Crossref 15. Melish ME: Bacterial skin infections , in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Disease . Philadelphia, WB Saunders Co, 1981, p 658. 16. Lennette EH, Spaulding EH, Truant JP (eds): Manual of Clinical Microbiology , ed 2. Washington, DC, American Society for Microbiology, 1974. 17. Rubin L, Moxon ER: Pathogenesis of bloodstream invasion with Haemophilus influenzae, type b . Infect Immun 1983;41:280-284. 18. Feigin RD: Bacterial meningitis beyond the neonatal period , in Feigin RD, Cherry JD (eds): Textbook of Pediatric Infectious Disease . Philadelphia, WB Saunders Co, 1981, pp 293-308. 19. Rotbart HA, Globe MP: Haemophilus influenzae type b septic arthritis in children: Report of 23 cases . Pediatrics 1985;75:254-259. 20. Thirumoorthi MC, Asmar BI, Dajani AS: Violaceous discoloration in pneumococcal cellulitis . Pediatrics 1978;62:492-493. 21. Lagergård T, Branefors P: Nature of cross-reactivity between Haemophilus influenzae types a and b and Streptococcus pneumoniae types 6A and 6B . Acta Pathol Microbiol Immunol Scand C 1983;91:371-376. 22. Murphy TV, Granoff D, Chrane DF, et al: Pharyngeal colonization with Haemophilus influenzae type b in children in a day care center without invasive disease . J Pediatr 1985;106:712-716.Crossref 23. Hampton CM, Barenkamp SJ, Granoff DM: Comparison of outer membrane protein subtypes of Haemophilus influenzae type b isolates from healthy children in the general population and from diseased patients . J Clin Microbiol 1983;18:596-600. 24. Todd JK: Bacteriology and clinical relevance of nasopharyngeal and oropharyngeal cultures . Pediatr Infect Dis 1984;3:159-163.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1986

References