Facial Cellulitis (Child)
Cellulitis is an infection of the deep layers of skin. A break in the skin, such as a cut or scratch, can let bacteria under the skin. It may also occur from an infected pimple (oil gland) or hair follicle. Cellulitis can affect anyone, but it is more common in children with a weak immune system, such as from cancer or an organ transplant.
Facial cellulitis is an infection of the skin on the face. It often occurs on the cheeks. It can also occur behind or around the eyes, on the neck, or behind the ears. Cellulitis causes the affected skin to become red, swollen, warm, and sore. The reddened areas have a visible border. An open sore may leak fluid (pus). Your child may have a fever, chills, and pain. A young child may be fussy, cry, and be hard to soothe.
Cellulitis is treated with antibiotics. In most cases, medicine taken by mouth is used, but in severe situations or with infections around the eye, I.V. (in the vein) antibiotics may be used. Symptoms should get better 1 to 2 days after treatment is started. In some cases, symptoms can come back.
If not treated, the bacteria can get into the eyes, bloodstream, and lymph nodes. The infection can then spread throughout the body. This causes serious illness.
Home care
Your child's health care provider will give you an antibiotic to treat the infection. Make sure to give all of this medicine for the full number of days until it's gone. Keep giving the antibiotic even if your child is better. Your child's provider may also tell you to use medicine to reduce fever and swelling. Follow the provider’s instructions for giving these medicines to your child. Don't give aspirin or products that contain aspirin to anyone under 19 years of age who is ill. It may cause a rare but serious illness called Reye syndrome that can result in liver and brain damage.
General care
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Have your child rest as much as possible until the infection starts to get better.
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Hold infants upright. Have an older child sit upright as much as possible. This can help reduce swelling in the face.
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Follow the health care provider’s instructions to care for an open wound and change any dressings.
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Keep your child’s fingernails short to reduce scratching.
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Wash your hands with soap and clean, running water before and after caring for your child. This is to prevent spreading the infection.
Follow-up care
Follow up with your child’s health care provider, or as advised.
When to get medical advice
Contact your child's health care provider or get medical care right away if your child has:
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Fever (see "Fever and children" below).
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Symptoms that don’t get better with treatment.
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Swollen lymph nodes on the neck or under the arm.
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Swelling around the eyes or behind the ears.
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Excessive drooling, neck swelling, or muffled voice.
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Redness or swelling that gets worse.
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Pain that gets worse.
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Bad-smelling fluid coming from the affected area.
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Blackened skin.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.
Below are guidelines to know if your young child has a fever. Your child’s provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
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First, ask your child’s provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher
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Armpit: 101°F (38.3°C) or higher
Call the provider in these cases:
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Repeated temperature of 104°F (40°C) or higher in a child of any age
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Fever of 100.4° (38°C) or higher in baby younger than 3 months
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Fever that lasts more than 24 hours in a child under age 2
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Fever that lasts for 3 days in a child age 2 or older