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Periorbital cellulitis in infancy
1Jules Stein Eye Institute, Torrance, Calif.
Insights
Infantile periorbital cellulitis differs between neonates and older infants. Neonates show more dacryocele issues and unknown infection sources, while older infants have more upper respiratory infections.
Area of Science:
- Pediatrics
- Ophthalmology
- Infectious Diseases
Background:
- Periorbital cellulitis is an infection around the eye.
- Previous studies have not specifically focused on infants under one year of age.
Purpose of the Study:
- To investigate the specific characteristics of infantile periorbital cellulitis in neonates versus older infants.
- To compare clinical presentation, etiology, and bacteriology between these two infant groups.
Main Methods:
- Retrospective study of 30 infantile periorbital cellulitis cases treated between 1977 and 1988.
- Analysis of patient demographics, clinical findings, radiological results, bacteriological data, and treatment outcomes.
Main Results:
- Infants older than one month showed similarities to older children in etiology and course.
- Neonates (7-30 days old) had a higher incidence of ruptured dacryocele and unknown infection source compared to older infants.
- Neonates had a lower incidence of preceding upper respiratory infection, abnormal sinus films, and positive blood cultures.
- Hemophilus sp. was the most common pathogen in older infants, while Streptococcus and Staphylococcus predominated in neonates.
- All cases remained preseptal and responded to intravenous antibiotics.
Conclusions:
- Significant differences exist in the presentation and etiology of periorbital cellulitis between neonates and older infants.
- Ruptured dacryocele and unknown sources are more prevalent in neonates.
- Bacterial pathogens vary between neonates and older infants.
- Prompt antibiotic treatment leads to favorable outcomes for preseptal infections.
Abstract:
To our knowledge, no previous study of periorbital cellulitis has focused on its specific characteristics in infants only (less than 1 year of age.) We retrospectively studied 30 cases of infantile periorbital cellulitis treated at Harbor-UCLA Medical Center from 1977 to 1988. Characteristics of the disorder in our infants older than 1 month were similar to earlier reports of older children in terms of etiology, radiological and bacteriological findings, and course. However, compared with our older infants, our seven neonates (7 to 30 days old) had a higher incidence of ruptured dacryocele (29% vs 0%) and unknown source of the infection (43% vs 4%); but a lower incidence of preceding upper respiratory infection (14% vs 78%), abnormal sinus films (0% vs 22%), and positive blood cultures (14% vs 30%). Of the positive cultures, Hemophilus sp was the most common pathogen among the older infants (35%), while Streptococcus and Staphylococcus were the most frequent among the neonates (71%). All infections remained preseptal and responded well to intravenous antibiotics.