Buccal cellulitis reevaluated
S. A. Chartrand and C. J. Harrison
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.
