Cellulitis:
A parent's guide for infants and babies

Although your child's doctor may easily diagnose cellulitis, he or she may wish to order other procedures such as blood tests or a skin biopsy. In addition, the doctor may perform a bacterial culture to find out what type of bacteria may be causing the cellulitis.

In the culture procedure, the doctor will:

1. Penetrate any blisters or pus-filled pockets with a needle, scalpel, or small blade (lancet).
2. Rub a sterile cotton swab across the skin to collect the sample.
3. Send the specimen away to a laboratory for evaluation.

If there are many bacteria present in the sample, the laboratory will usually have some idea of what type it is within 48–72 hours. However, the culture may take a full week or more to produce final results. In addition to identifying the type of bacteria that is causing the cellulitis, the laboratory usually performs a test (antibiotic sensitivity testing) to determine which antibiotics will be most effective in killing off the bacteria.
 
While waiting for the results from the bacterial culture, the doctor will probably want to start your child on an antibiotic to fight the most common bacteria that cause cellulitis. Once the final culture results have returned, the physician may change the antibiotic, especially if your child is not improving on the one initially prescribed.

Mild cases of cellulitis in otherwise healthy people can be treated on an outpatient basis with oral antibiotic pills or syrups. Common oral antibiotics that are used to treat cellulitis include:

• Dicloxacillin
• Cephalexin
• Trimethoprim-sulfamethoxazole
• Clindamycin
• Erythromycin

However, ill-appearing children who have other illnesses, or those who have cellulitis of the face, may need to be admitted to the hospital for observation and so they can receive injected (intravenous) antibiotics. Common intravenous antibiotics used in hospitals to treat cellulitis include:

• Nafcillin
• Oxacillin
• Cefazolin
• Vancomycin
• Linezolid

If your child's doctor prescribes antibiotics, be sure the child takes the full course of treatment. In addition to prescribing antibiotics, the doctor will likely want to make sure that your child has no other medical problems.