Subgaleal Abscess Following Staphylococcal Cellulitis in a 10-Month-Old Child: A Diagnostic Challenge for the Clinician

Subgaleal abscess is an extremely rare and unusual presentation of head and neck infections and has been reported to occur following scalp infections, head trauma, sinusitis, septicemia, scalp monitoring, and surgical interventions. We report a 10-month-old child who presented with cellulitis around a pustule on the right forehead of three days duration. It was initially treated with oral cloxacillin for five-days. However, the child went on to develop a high continued fever on the day of discharge and remained febrile and unwell for seven days until a subgaleal abscess was identified and surgical drainage was performed. Pus cultures grew Staphylococcus aureus, which was sensitive to flucloxacillin. Following drainage of the abscess and change of antibiotics to intravenous flucloxacillin, fever completely subsided and the child made a complete clinical recovery. This report highlights the importance of having a high clinical suspicion of this rare complication in children with continuing high spikes of temperature following skin infections in the head region.