Buccal Cellulitis in 3 Infants

Abstract

Three patients are reported with buccal cellulitis. All were between 4 months and 6 months of age. Two patients had received two sets of immunizations, the other patient had received three sets, but the third set was only three days prior to onset of illness. This is an age where protective maternal antibodies would be absent or at a low level. Active immunization with Pentacel is effective after three injections starting at two months of age. All infants were using a pacifier with this thin hard plastic “wings” that contacted the skin sites where cellulitis developed. A break in the skin surface predisposes to development of cellulitis. It is felt that their unprotected antibody status and probable minor skin abrasion from the pacifier wings contributed to their acquiring buccal cellulitis. Antibiotic selection, immunization schedules, and pacifier usage were discussed.