Vaccination site reaction or bacterial cellulitis?

Abstract

Large inflammatory reactions are relatively common after pre-school boosters, whereas injection-related bacterial cellulitis is vanishingly rare. By taking note of the minimal tenderness, fever and toxicity present with the former, paediatricians should be able to avoid unnecessary antibiotic treatment for the latter and reassure parents of the likelihood of spontaneous resolution over several days. However, to avoid missing an instance of bacterial cellulitis at an early stage, it would be prudent to ask parents to report any unexpected progression in fever, toxicity or lesional discomfort so that the situation can be reassessed. The Upshots column in Paediatrics & Child Health is meant to address practical questions without ready answers in standard references such as the Red Book or the Canadian Immunization Guide. Readers are invited to submit questions to the Journal office. A timely response will be provided, whenever possible, from one member of a panel of experts. The most interesting exchanges will be selected for publication. Submitters should identify themselves, but will be given the option of anonymity in the published version. Submit questions directly to ac.spc@lanruoj. Please note that these may be edited for clarity and brevity. David Scheifele MD Associate Editor, Paediatrics & Child Health