Buccal cellulitis.
 Buccal cellulitis (BC) is an innocuous appearing infection of the cheek that is found in children and has a high incidence of concomitant bacteremia.
 Typically, the child is younger than 12 months and has a 2 to 8 hour prodrome of coryza and fever before developing the cellulitis on the cheek.
 A purplish hue on the cellulitic region is highly suggestive of Hemophilus influenzae bacteremia.
 The differential diagnosis is reviewed.
 A complete blood count, blood culture, and cellulitis aspirate culture, should be obtained on all patients with BC.
 Meningitis may be present despite the lack of meningeal signs.
 A lumbar puncture should be performed on all children at risk for bacteremic BC.
 The vast majority of these children are bacteremic and require parenteral antibiotics.
 A typical case of BC is presented and its management is reviewed.
