Red flags & when to go in person for Cellulitis (Mild) - Triage

Audience: pediatric

Cellulitis is a common skin infection that causes redness, swelling, and warmth, often affecting children. Mild cellulitis can sometimes be managed with telemedicine, where a healthcare provider evaluates symptoms remotely. However, certain warning signs or "red flags" mean your child should be seen in person promptly. These include high fever, spreading redness, severe pain, or signs of infection spreading to deeper tissues. Telemedicine can help guide initial care, provide advice, and monitor mild cases, but it cannot replace hands-on examination or urgent treatment when symptoms worsen. Knowing when to seek in-person care helps keep your child safe and ensures timely treatment. This guide explains what cellulitis looks like, when to use telemedicine, and when to go to a healthcare facility for your child.

Red flags — go in person / ER

• High fever above 38.5°C (101.3°F) — seek urgent in-person care.
• Rapidly spreading redness or swelling — go to a healthcare facility promptly.
• Red streaks extending from the infected area or severe pain — seek emergency evaluation.

What telemedicine can do

• Initial evaluation of mild cellulitis symptoms.
• Providing advice on home care and symptom monitoring.
• Deciding if oral antibiotics may be appropriate for mild cases.
• Scheduling follow-up to monitor progress.

What telemedicine cannot do

• High fever or signs of systemic illness.
• Rapidly spreading or worsening infection.
• Severe pain or signs of deep tissue involvement.
• Need for intravenous antibiotics or surgical intervention.

What is Mild Cellulitis in Children?

Mild cellulitis is a skin infection that causes redness, swelling, and tenderness. It often happens after a small cut or insect bite. In children, it usually affects the arms, legs, or face. The skin may feel warm and look pink or red. Mild cellulitis typically does not cause severe pain or high fever.

When Can Telemedicine Help?

Telemedicine allows you to talk with a healthcare provider by phone or video. For mild cellulitis, telemedicine can help by:

This can be convenient and reduce the need to travel, especially if symptoms are mild and stable.

When to Seek In-Person Care Immediately

Certain signs mean your child needs to be seen in person quickly:

These may indicate the infection is worsening or spreading deeper and needs urgent treatment.

How to Prepare for a Telemedicine Visit

Before your tele-visit, prepare by:

This helps the provider assess your child's condition accurately.

After the Telemedicine Visit: What to Do Next

Follow the provider's advice carefully. This may include:

If your child’s condition worsens, seek in-person care immediately.

How to prepare for your tele-visit

• Ensure good lighting to clearly show the affected skin area during the visit.
• Take clear photos of the affected area if possible to share with the provider.
• Have your child's symptom history ready, including when symptoms started and any changes.
• Prepare a list of current medications and allergies.
• Have a thermometer available to check and report your child's temperature.

After your tele-visit

• Follow the healthcare provider's instructions for medications and wound care.
• Keep the infected area clean and elevated if possible.
• Monitor your child closely for any worsening symptoms or new red flags.
• Schedule and attend any recommended follow-up visits.
• Seek immediate in-person care if red flags or worsening signs develop.

FAQs

Can mild cellulitis be treated at home?

Mild cellulitis may sometimes be treated at home with antibiotics prescribed by a healthcare provider, along with proper skin care. However, close monitoring is important to ensure the infection does not worsen.

How do I know if my child’s cellulitis is getting worse?

Watch for increasing redness, swelling, pain, fever, or red streaks near the infected area. If these occur, seek in-person medical care promptly.

Is telemedicine safe for evaluating cellulitis in children?

Telemedicine can be a safe way to assess mild cellulitis symptoms and provide guidance. However, it cannot replace physical exams when symptoms are severe or worsening.

What should I do if my child develops a fever with cellulitis?

If your child has a fever above 38.5°C (101.3°F), it is important to seek in-person medical evaluation as this may indicate a more serious infection.

Sources

1. Cellulitis — MedlinePlus, U.S. National Library of Medicine.
2. Skin and Soft Tissue Infections — Centers for Disease Control and Prevention (CDC).
3. Cellulitis - Symptoms and Causes — Mayo Clinic.
4. Cellulitis and Erysipelas — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation and care. If your child shows any red flags or worsening symptoms, seek immediate medical attention.