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Acute rhinosinusitis-related orbital infection in pediatric patients: a retrospective analysis

Shiang-Fu Huang1, Ta-Jen Lee, Yun-Shien Lee

  • 1Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan.

The Annals of Otology, Rhinology, and Laryngology
|April 23, 2011
PubMed

Insights

Fever and proptosis in children with periorbital swelling indicate a higher risk of subperiosteal orbital abscesses, often requiring surgery. Early identification of these symptoms is crucial for effective treatment of pediatric sinusitis-related infections.

Area of Science:

  • Ophthalmology
  • Pediatric Infectious Diseases
  • Otolaryngology

Background:

  • Periorbital infections in children commonly stem from acute rhinosinusitis.
  • Subperiosteal orbital abscesses can necessitate emergency surgical intervention for acute orbital swelling.

Purpose of the Study:

  • To identify characteristics of pediatric patients at risk for developing subperiosteal orbital abscesses.
  • To determine predictors for emergency surgery in acute orbital swelling cases.

Main Methods:

  • Observational retrospective cohort study of 64 children (<18 years) with periorbital swelling.
  • Diagnosis of periorbital cellulitis and subperiosteal orbital abscess confirmed radiographically and via CT scan showing concomitant sinusitis.

Main Results:

  • Fever and proptosis were independent predictors of abscess formation on multivariate analysis.
  • Factors associated with abscess formation included age ≤6 years, proptosis, fever, and elevated white blood cell count.
  • Commonly cultured microbes included Staphylococcus aureus, Streptococcus viridans, and coagulase-negative staphylococci; 29% had polymicrobial cultures.

Conclusions:

  • Abscess formation is a key predictor of antibiotic treatment failure in sinusitis-related periorbital infections.
  • Children presenting with fever and proptosis are more susceptible to developing subperiosteal orbital abscesses.
Abstract

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