Scratching the surface: a review of skin and soft tissue infections in children. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Fenster, Daniel B.; Renny, Madeline H.; Ng, Carrie; Roskind, Cindy G.
• Is Part Of: Current opinion in pediatrics. Volume 27:Issue 3(2015:Jun.)
• Publication Date: 2015-06
• Subjects: incision and drainage -- methicillin-resistant Staphylococcus aureus -- packing -- skin and soft tissue infection; Pediatrics -- Periodicals; Pediatrics -- Periodicals -- Bibliography -- Periodicals; 618.92
• DOI: 10.1097/MOP.0000000000000213
• Languages: English
• ISSNs: 1040-8703

Abstract

Abstract : Purpose of review: We present data from recently conducted research on the diagnosis and management of skin and soft tissue infections (SSTIs) in children. Recent findings: Current research in the area of SSTIs (cellulitis and abscess) has focused on the use of ultrasound, risk factors associated with bacteremia, antibiotic choice, and incision and drainage (I&D) practices. When clinical examination is equivocal at distinguishing abscess from cellulitis, ultrasound can aid in the diagnosis and alter management. Bacteremia is rare in immunocompetent children with uncomplicated SSTIs; blood cultures may be reserved for complicated cases and for those who are systemically ill. Despite the increased prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), I&D without antibiotics remains the first-line therapy for abscess. Antibiotics for uncomplicated cellulitis should target β-hemolytic streptococci and methicillin-susceptible S. aureus (MSSA). There are significant variations in pain and sedation practices for I&D, with substantive evidence for the use of topical anesthetics. Wound packing after I&D may not confer significant benefit. Summary: Evidence to aid in the diagnosis and management of SSTIs in children has emerged in recent years; however, larger prospective pediatric studies are needed.