826 FACIAL CELLULITIS IN CHILDREN: DIAGNOSIS BY NEEDLE ASPIRATION

Abstract

Facial cellulitis in 27 children between the ages of 2 months and 7 years was studied over a 15 month period. No child had received antibiotics for 2 weeks prior to the study. After obtaining a careful history, physical examination and informed consent, the area of inflammation was cleansed with iodine and alcohol. Local anesthesia was not utilized in this study. Aspiration was performed by inserting a sterile 20-gauge needle attached to a 1.0 ml-syringe into the advancing border of inflammation. If no material was aspirated, 0.1-0.2 ml of sterile normal saline was injected into the area and withdrawn.Twenty-one of 27 (77.7%) children had bacteria recovered by culture from the area of cellulitis. Twelve of 27 (44.4%) had organisms demonstrated by gram stain. Hemophilus influenza was recovered from 10 (37%) children, while Staphylococcus aureus and group A streptococcus accounted for 9 (33%) and 3 (11.1%) of the cases respectively. A single child had both staphylococcus and streptococcus cultured from his localized infection. One strain of Hemophilus influenza was resistant to ampicillin. No complications were encountered using the needle aspiration procedure.Needle aspiration and culturing are reliable techniques to demonstrate bacterial pathogens associated with facial cellulitis in children.