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[Orbital and periorbital cellulitis. Review of 107 cases]
Rodríguez Ferran L1, Puigarnau Vallhonrat R, Fasheh Youssef W
1Servicio de Pediatría. Unidad Integrada Hospital Sant Joan de Déu Hospital Clínic. Esplugues de Llobregat. Barcelona.
Aim:
To report the epidemiology, clinical features, management and complications of orbital and periorbital cellulitis; to evaluate the use of imaging tests in the detection of complications.
Methods:
Retrospective study of 107 pediatric patients admitted to the San Joan de Déu Pediatric Hospital with orbital or periorbital cellulitis from January 1991 to January 1999.
Results:
The incidence of cellulitis was highest in the second year of life and during winter. No significant differences were found between the sexes. In 68 patients (63.6%) the cause of cellulitis was identified as sinusitis. The most frequently identified organisms were Staphylococcus aureus, Streptococcus pneumoniae and S. pyogenes. Computed tomography identified retroseptal damage in 36 patients with 23 super osteal abscesses, 3 orbital abscesses and 3 intracranial complications. Sixty nine percent of the patients were treated with a single antibiotic (cefotaxime, cefuroxime or amoxicillin clavulanic acid) while 31% underwent multiple antibiotic therapy. Only 8.4% required surgery.
Conclusions:
Orbital cellulitis is a relatively common and potentially serious disease in children. The early use of CT to assess the extent of damage is important in establishing prognosis and in assessing the need for surgical therapy.