Juvenile cellulitis

[2] The first symptom is a sudden onset of swelling of the face, which develops within two days into papules and pustules on the lips, nose, and around the eyes.

Less common symptoms include pyrexia, anorexia, and joint pain caused by sterile suppurative arthritis.

[2] Cytologic examination of aspirates of affected lymph nodes, pustules, abscesses, and joint fluid rarely reveal bacteria, and culture results of intact lesion are always negative for bacterial growth, suggesting a nonbacterial etiology.

Cytologic examination of papulopustular lesions of juvenile cellulitis reveals pyogranulomatous inflammation with no microorganisms and carefully performed cultures are negative.

Biopsies of early lesions reveal multiple discrete or confluent granulomas and pyogranulomas consisting of clusters of large epithelioid macrophages with variably sized cores of neutrophils.