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e-TABLE 94.11 PREVALENCE OF URINARY TRACT INFECTION IN FEBRILE CHILDREN YOUNGER THAN 24 MONTHS Age (mo) Prevalence (%) Females: Prevalence (%) Males: Prevalence % 0–1 >1–3 >3–6 >6–9 >9–12 >12–18 6.9 5.5 3.6 2.1 1.4 0.8 5.1 5.9 5.1 3.7 2.3 1.4 8.5 5.3 2.5 0.8 0.7 0.4 >18–24 0.8 1.4 0.3 Modified from Bachur R, Harper M Reliability of the urinalysis for predicting urinary tract infections in young febrile children Arch Pediatr Adolesc Med 2001;155:60–65 e-TABLE 94.12 COMMON ETIOLOGIES FOR CELLULITIS Scenario Etiologies Facial cellulitis (buccal, S aureus, GAS, periorbital) pneumococcus Erysipelas Predominantly GAS Odontogenic Usually polymicrobial: viridans group streptococci, Prevotella, Fusobacterium Cellulitis in patients with lymphedema GAS most common, S aureus Trunk or extremities Perineal Perianal cellulitis S aureus, GAS Often polymicrobial: S aureus, GAS, enteric GNRs, Bacteroides and other anaerobes GAS Cellulitis after water exposure S aureus, GAS, Vibrio vulnificus, Comments Hib cellulitis rare in vaccinated children Raised, beefy red, very well-demarcated borders; most common on the legs; if see involvement of the ear (Milian ear sign), likely erysipelas Abscess drainage essential; one complication can be Ludwig angina, a rapidly progressive cellulitis of the floor of the mouth that can result in airway obstruction Some patients may benefit from oral PCN VK prophylaxis if have recurrent episodes Over 70% are S aureus One risk factor in adolescents is shaving the genital area Rapid strep swabs, while not licensed outside the nasopharynx, can help guide initial therapy Vibrio causes rapidly progressive cellulitis with bullae formation Aeromonas, other water pathogens and ecchymoses after contact with brackish or coastal water; it has also been associated with puncture wounds from stingrays and fish Cellulitis after animal Pasteurella multocida, S More common after cat bite aureus, GAS; bites, which result in Capnocytophaga deep punctures that are canimorsus more difficult to irrigate thoroughly; symptoms begin within 24 hrs Use of amoxicillinclavulanate after animal bites (or clindamycin + trimethoprimsulfamethoxazole for PCN-allergic patients) is targeted to decrease the risk of P multocida infection Can also see gram-positive infections from inoculation of the child’s skin flora deep into a wound C canimorsus most common in immunocompromised hosts after dog bites or dogs licking open wounds Cellulitis after clenched Eikenella corrodens, Aerobic and anaerobic fist injury anaerobes; often cultures should be sent; polymicrobial from in some case series, oral flora most pathogens are PCN-susceptible Plantar, following S aureus, GAS, In some series,