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Current treatment and outcome in orbital cellulitis
1Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Australian and New Zealand Journal of Ophthalmology
|January 21, 2000
Summary
Bacterial orbital cellulitis, often linked to sinus disease, rarely causes severe complications with modern treatment. Prompt diagnosis and antibiotic therapy are key to preventing vision loss and other serious outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatrics
Background:
- Bacterial orbital cellulitis is an uncommon infection.
- Historically associated with severe complications and mortality.
- Current diagnostic and treatment strategies require evaluation.
Purpose of the Study:
- To describe current investigations and treatment for bacterial orbital cellulitis.
- To establish the effectiveness of these interventions.
- To report the incidence of complications and surgical interventions.
Main Methods:
- Retrospective chart review of 52 patients diagnosed with orbital cellulitis.
- Inclusion criteria: patients admitted to Royal Victorian Eye and Ear Hospital and Royal Children's Hospital, Melbourne.
- Data collected: July 1993 to July 1997.
Main Results:
- Paranasal sinus disease was the most common predisposing factor, particularly in children.
- Clinical diagnosis with radiological confirmation was standard; microbiological yield varied.
- Staphylococci and Streptococci were the most common isolates; blood cultures were unhelpful.
- Treatment involved intravenous antibiotics, with surgery for abscess drainage when necessary.
- Permanent visual impairment was rare; one case of enucleation for endophthalmitis occurred.
Conclusions:
- Adequately treated orbital cellulitis has low morbidity today.
- Paranasal sinus disease remains the primary cause.
- Cultures from sinuses or abscesses yield the best microbiological results.