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Cellulitis

Cellulitis is an infection of the deep layers of the skin. It can occur at any age.

Common symptoms of cellulitis:

  • A spreading area of redness of the skin, which is usually warm to touch
  • Pain or discomfort at the site
  • Swelling of the affected area may occur
  • Fever may be present
  • They may have swollen glands (lymph nodes) near the area of infected skin. 
When should you worry?

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Is going blue around the lips
  • Too breathless to talk / eat or drink
  • Has a fit/seizure
  • Seems dehydrated (sunken eyes, drowsy or not had a wee or wet nappy for 12 hours)
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the 'Glass Test')
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Is between 3-6 months of age with a temperature over 39°C

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If you child has any of the following:

  • Increasing pain or worsening/spreading red area
  • Seems dehydrated (sunken eyes, drowsy or not had a wee or wet nappy for eight hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breath in)
  • Fever of 38.0°C or above with other symptoms/signs of cellulitis
  • Is getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

If none of the above features are present

Self care

Continue providing your child’s care at home. If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit 111.nhs.uk

This guidance has been reviewed and adapted by healthcare professionals across Shropshire, Telford and Wrekin with consent from the Hampshire development groups.

Causes of cellulitis

Cellulitis often follows injury to the skin, which may be minor, such as a scratch or insect bite. It can also occur following surgery. It occurs more commonly in children with an underlying skin condition (such as eczema) or in children with diabetes.

Treatment

Cellulitis usually responds well to oral antibiotics. Your child should begin to show improvement within two to three days. Treatment with intravenous antibiotics (given into a vein) is very occasionally needed for more severe cases of cellulitis or those that are worsening despite antibiotics being given by mouth. Antibiotics are usually given for a total of 5 days.

If your child has any features of severe infection (amber or red features above), they will need to be urgently seen by a healthcare professional who may decide that your child may benefit from antibiotic treatment.

You can help relieve symptoms by:

  • Giving your child paracetamol or ibuprofen if they are in pain or have a fever
  • Encourage your child to drink plenty of fluids

Prevention

Not all cases of cellulitis can be prevented, but steps can be taken to reduce the risk of it developing. Cuts, grazes, or bites should be cleaned immediately. Keep the wound covered with a clean plaster or dressing. This will create a barrier against bacteria entering the skin.

Also remember good hand hygiene. Encourage your child to wash their hands regularly and always wash your hands when treating a wound or skin condition.

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