Vaccination site reaction or bacterial cellulitis?

Large inflammatory reactions are relatively common after pre-school boosters, whereas injection-related bacterial cellulitis is vanishingly rare. By taking note of the minimal tenderness, fever and toxicity present with the former, paediatricians should be able to avoid unnecessary antibiotic treatment for the latter and reassure parents of the likelihood of spontaneous resolution- over several days. However, to avoid missing an instance of bacterial cellulitis at an early stage, it would be prudent to ask parents to report any unexpected progression in fever, toxicity or lesional discomfort so that the situation can be reassessed.