Intracranial infection associated with preseptal and orbital cellulitis in the pediatric patient

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Dorothy J Reynolds1, Sylvia R Kodsi, Steven E Rubin

  • 1Department of Ophthalmology, North Shore--Long Island Jewish Health System, Great Neck, NY, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|January 20, 2004
PubMed

Insights

Children with preseptal or orbital cellulitis and signs like headache or fever may have intracranial infections. Prompt diagnosis and broad-spectrum antibiotics are crucial for managing these serious pediatric infections.

Area of Science:

  • Pediatric infectious diseases
  • Ophthalmology
  • Neurosurgery

Background:

  • Preseptal and orbital cellulitis are common pediatric infections.
  • Intracranial complications can arise from these infections, necessitating prompt recognition and management.

Purpose of the Study:

  • To identify risk factors associated with intracranial infections in children diagnosed with preseptal or orbital cellulitis.
  • To improve diagnostic and treatment strategies for pediatric patients with these conditions.

Main Methods:

  • Retrospective chart review of 10 pediatric patients (<= 18 years) with preseptal/orbital cellulitis and intracranial infection.
  • Analysis of diagnoses, microbial cultures, and treatment interventions.

Main Results:

  • Common diagnoses included sinusitis, orbital subperiosteal abscess, Pott's puffy tumor, epidural empyema/abscess, and brain abscess.
  • Polymicrobial infections (Streptococcus, Staphylococcus) were frequent, requiring broad-spectrum antibiotics.
  • All patients needed medical and surgical treatment, including sinus surgery, craniotomy, and orbital surgery.

Conclusions:

  • Suspect intracranial involvement in children >= 7 years with orbital cellulitis, sinusitis, headache, or persistent fever.
  • Broad-spectrum antibiotics are indicated due to high rates of polymicrobial infections.
  • Include brain imaging when evaluating orbits and sinuses to rule out intracranial spread.
Abstract

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