{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:07:28Z","timestamp":1788588448475,"version":"build-2803163510"},"reference-count":7,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,3,1]]},"abstract":"<jats:p>Objective.\u2003To evaluate the yield of blood cultures obtained from immunocompetent children admitted for cellulitis in the post-Haemophilus influenzae type b (Hib) vaccine era and to determine whether these cultures are cost-effective.<\/jats:p>\n                  <jats:p>Design.\u2003Retrospective case series.<\/jats:p>\n                  <jats:p>Setting.\u2003Urban pediatric emergency department.<\/jats:p>\n                  <jats:p>Study Population.\u2003Patients 2 days to 22 years of age admitted with cellulitis from 1994 through 1995.<\/jats:p>\n                  <jats:p>Measurements and Results.\u2003Of 381 patients identified, 266 (70%) had blood cultures and 243 of these children were enrolled. Data recorded include demographics, immunization status, initial clinical appearance, antibiotic pretreatment, preexisting illness, location and precipitating cause of cellulitis, white blood cell count, and band-to-neutrophil ratio (BNR). Blood cultures were categorized as positive, negative, or contaminant. Five cultures (2%) were positive, and 13 (5.4%) were contaminants. The positive blood cultures grew streptococcus and staphylococcus organisms, and none of the children were bacteremic with H influenzae. All patients with group A \u03b2-hemolytic streptococcus had active varicella. The mean age was lower (26 vs 75 months) in those with a positive blood culture, and mean BNR was higher (0.32 vs 0.07). Patient management did not change for bacteremic patients with uncomplicated cellulitis. All repeat cultures were negative. The cumulative charge for all blood cultures was $50\u2009986.<\/jats:p>\n                  <jats:p>Conclusions.\u2003Blood cultures are not cost-effective and are more frequently contaminated than positive in the evaluation of a patient with uncomplicated cellulitis. Since introduction of theH influenzae type b vaccine, the most common organisms are streptococci. Using a BNR = 0.20 as a threshold for sending blood cultures, we would have missed one positive culture, but would have avoided blood cultures in 213 patients (88%) with an estimated savings of $42\u2009850.<\/jats:p>","DOI":"10.1542\/peds.101.3.e4","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:44:32Z","timestamp":1092426272000},"page":"e4-e4","source":"Crossref","is-referenced-by-count":51,"title":["Blood Cultures in the Evaluation of Children With Cellulitis"],"prefix":"10.1542","volume":"101","author":[{"given":"Karin Berger","family":"Sadow","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"},{"name":"Emergency Medicine, George Washington University School of Medicine and Health Sciences and Children's Hospital, Washington, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,3,1]]},"reference":[{"key":"2021121000253534500_B1","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S0022-3476(80)80014-X","article-title":"Cellulitis. Bacterial etiology, clinical features, and laboratory findings.","volume":"97","author":"Fleisher","year":"1980","journal-title":"J Pediatr."},{"key":"2021121000253534500_B2","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1097\/00007611-198105000-00006","article-title":"Cellulitis: analysis of 101 cases and review of the literature.","volume":"74","author":"Ginsberg","year":"1981","journal-title":"South Med J."},{"key":"2021121000253534500_B3","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/0735-6757(90)90160-2","article-title":"Buccal cellulitis.","volume":"8","author":"Walker","year":"1990","journal-title":"Am J Emerg Med."},{"key":"2021121000253534500_B4"},{"key":"2021121000253534500_B5","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0196-0644(96)70083-5","article-title":"Changing bacteriology of periorbital cellulitis.","volume":"28","author":"Schwartz","year":"1996","journal-title":"Ann Emerg Med."},{"key":"2021121000253534500_B6","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1542\/peds.96.3.428","article-title":"Group A \u03b2-hemolytic streptococcal bacteremia: historical overview, changing incidence, and recent association with varicella.","volume":"96","author":"Doctor","year":"1995","journal-title":"Pediatrics."},{"key":"2021121000253534500_B7","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/00006454-199602000-00011","article-title":"Invasive group A streptococcal infections in children with varicella in Southern California.","volume":"15","author":"Vugia","year":"1996","journal-title":"Pediatr Infect Dis J."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/3\/e4\/827319\/e4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/3\/e4\/827319\/e4.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T01:33:00Z","timestamp":1682731980000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/101\/3\/e4\/61924\/Blood-Cultures-in-the-Evaluation-of-Children-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,3,1]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1998,3,1]]},"published-print":{"date-parts":[[1998,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.101.3.e4","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,3,1]]}}}