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How Many Weeks Of Bed Rest Is Necessary For Cellulitis In Children?
Question: My daughter (23 months old/female/weighs 10kgs) has developed cellulitis on her right foot. We brought her to the doctor because she complained of pain, the area infected was approximately 3 cms long the whole width of her foot was red, swollen and hot to touch. They did a ultrasound (no puss found), and xray (no abnormalities) and a blood test. Once the results were received she was admitted and put on an IV and nurses inject Cefazedone Sodium 3 times a day. My question: the doctor wants to keep our daughter admitted for one to two weeks. Does that seem excessive? We live in South Korea and the medical system usually over prescribe treatment (especially hospital stays) to increase the insurance claim. Is there an oral antibiotic that's appropriate once the infection is reduced. Please see the attached blood test report. Right her foot is immobilized, raised and we need to apply an ice pack every hour to reduce the swelling. Her foot was not excessively swollen when was admitted yesterday. Needless to say keeping a toddler still and on bed rest for a week seems almost impossible. Thank you.
Brief Answer:
MRI if possible, oral antibiotic and anti-inflammatory medicines
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Read and understood the problem your daughter has, admission to hospital, inability to confine the child to the bed, the reports you have provided and all.
Requesting you the following feedback:
Was there any history of injury? Even trivial?
Fever anytime?
Is 10 kg normal for a bay of 23 months in your country?
Please attach the photograph of the foot as
YYYY@YYYY
You may be right, but since I don know much about the medical system in South Korea, but Insurance industry has changed the scenario all over the world, and the Insurance company wants the early discharge to avoid paying more.
Well, the more important issue is the health of your daughter.
-If the swelling is reduced, oral antibiotics can always be started if teh patient is tolerating and not having vomiting.
- When X-ray and Ultrasonography are not showing pus, the more appropriate investigations is MRI study as it can even show the degree of inflammation in the soft tissues and bones too. (CT is better avoided in small child as it gives radiation- MRI does not give radiation).
- Icing does not work beyond 24 hours and in fact be more irritating to a small child. You may stop it.
- Let MRI report be done if your Doctors agree, so that further course of action be decided.
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.
MRI if possible, oral antibiotic and anti-inflammatory medicines
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Read and understood the problem your daughter has, admission to hospital, inability to confine the child to the bed, the reports you have provided and all.
Requesting you the following feedback:
Was there any history of injury? Even trivial?
Fever anytime?
Is 10 kg normal for a bay of 23 months in your country?
Please attach the photograph of the foot as
YYYY@YYYY
You may be right, but since I don know much about the medical system in South Korea, but Insurance industry has changed the scenario all over the world, and the Insurance company wants the early discharge to avoid paying more.
Well, the more important issue is the health of your daughter.
-If the swelling is reduced, oral antibiotics can always be started if teh patient is tolerating and not having vomiting.
- When X-ray and Ultrasonography are not showing pus, the more appropriate investigations is MRI study as it can even show the degree of inflammation in the soft tissues and bones too. (CT is better avoided in small child as it gives radiation- MRI does not give radiation).
- Icing does not work beyond 24 hours and in fact be more irritating to a small child. You may stop it.
- Let MRI report be done if your Doctors agree, so that further course of action be decided.
I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more or if you need further clarifications or if you feel there is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
To answer your questions: 1) she had a scrape on her ankle which the doctor said was probably the cause. 2) She hasn't had a fever. 3) She's in the lower percentile for her weight but she's very healthy and active. Her pediatrician isn't concerned.
What oral medication can be prescribed to treat cellulitis in toddlers?
The redness is gone and the swelling is almost gone. What is an appropriate amount of time to receive to receive medication via an IV?
Once medication has begun, how important is immobilization? We're having an impossible time with her IV and foot wrapping.
What oral medication can be prescribed to treat cellulitis in toddlers?
The redness is gone and the swelling is almost gone. What is an appropriate amount of time to receive to receive medication via an IV?
Once medication has begun, how important is immobilization? We're having an impossible time with her IV and foot wrapping.
Brief Answer:
As discussed.
Detailed Answer:
Thanks for your feedback and clear photograph, you have got a cute baby.
As per your history, scrape on her ankle can be a cause, no fever, good that the pediatrician is not bothered for her weight.
The Almighty really bestows on children, they are so innocent hence they heal also very very fast as seen here. She should recover fast as per the descriptions you have provided.
100% yes, the oral medicines can be prescribed in toddlers. Sorry to say that these are to be prescribed by the local Doctor for the Pharmacy to give you the medicines. Your Doctor would most probably be prescribe the oral medicine of the same group.
The usual practice is to give IV injection fro 3 to 5 days. The benefit of IV injection is that the calculated dose goes directly into the blood, thereby the patient receives the most apt dose.
Immobilization helps containment of the cellulitis, gives rest to the ailing part of the body, helps faster recovery; but in children is it really difficult to apply this, as also the intravenous fluid canula.
Well, please discuss these all the points with your treating Doctor, the intermediate solution will definitely be found.
I hope this helps.
You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant
As discussed.
Detailed Answer:
Thanks for your feedback and clear photograph, you have got a cute baby.
As per your history, scrape on her ankle can be a cause, no fever, good that the pediatrician is not bothered for her weight.
The Almighty really bestows on children, they are so innocent hence they heal also very very fast as seen here. She should recover fast as per the descriptions you have provided.
100% yes, the oral medicines can be prescribed in toddlers. Sorry to say that these are to be prescribed by the local Doctor for the Pharmacy to give you the medicines. Your Doctor would most probably be prescribe the oral medicine of the same group.
The usual practice is to give IV injection fro 3 to 5 days. The benefit of IV injection is that the calculated dose goes directly into the blood, thereby the patient receives the most apt dose.
Immobilization helps containment of the cellulitis, gives rest to the ailing part of the body, helps faster recovery; but in children is it really difficult to apply this, as also the intravenous fluid canula.
Well, please discuss these all the points with your treating Doctor, the intermediate solution will definitely be found.
I hope this helps.
You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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