Introduction, Important History and Examination
Introduction Important details on history Important details on examination SETTING Primary and Secondary Healthcare Institutions in the Western Cape which refer to Red Cross War Memorial Children’s Hospital (RCWMCH) FOR STAFF Primary and Secondary Doctors and Nurses who refer patients to RCWMCH PATIENTS Patients under the age of 13 years old with skin and soft tissue infections Introduction Skin
Important details on examination
SETTING
Primary and Secondary Healthcare Institutions in the Western Cape which refer to Red Cross War Memorial Children’s Hospital (RCWMCH)
FOR STAFF
Primary and Secondary Doctors and Nurses who refer patients to RCWMCH
PATIENTS
Patients under the age of 13 years old with skin and soft tissue infections
Introduction
Skin and soft tissue infections are a common problem in the paediatric population. Most of these infections can be managed with antimicrobial therapy, or with simple incision and drainage if there is abscess formation.
Clinicians should be on the look-out for deeper, more severe infections such as necrotizing fasciitis and pyomyositis. Patients with these deeper infections need aggressive resuscitation and then urgent referral for definitive therapy by paediatric surgery.
This guideline aims to assist doctors and nurses in managing simple infections with appropriate care at the primary and secondary level of care. It will also assist in ensuring clinicians know the signs of deeper infections and when referral to paediatric surgery is the appropriate management plan.
Important details on history
- How long has the lesion been present?
- Is there a history of trauma?
- How did the infection start and how has it evolved in the meantime?
- Are there associated symptoms of systemic illness?
- Does the child have any comorbidities?
Important details on examination
Assess the lesion for redness, swelling, fluctuance and surrounding induration.
It is helpful to mark the edge of erythema with a marker so that an objective assessment of spread can be made on clinical review.
Assess if the patient can bare weight on the involved limb.
Confirm that there is no limitation on movement in the affected limb.
Reluctance to weight bare or move an affected limb should prompt you to consider septic arthritis and to do an Xray of the affected area to exclude osteomyelitis.
Children's Surgery Network, Western Cape Government, Red Cross War Memorial Children’s Hospital (RCWMCH), Clinical Guideline_Version 1_2025
Skin and Soft Tissue Infections_Introduction; Important details on history; Important details on examination