Complete manuscript title: Neurological complications from sinugenic orbital cellulitis.

Area of Science:

• Ophthalmology
• Neurology
• Infectious Diseases

Background:

• Orbital cellulitis is a serious infection that can lead to severe complications.
• Neurological complications associated with orbital cellulitis require further investigation to identify risk factors and trends.

Purpose of the Study:

• To identify common factors and trends in patients with orbital cellulitis who develop neurological complications.
• To analyze the relationship between orbital collection site, sinus involvement, and neurological outcomes.

Main Methods:

• A 24-month retrospective review of patients treated for orbital cellulitis at Manchester Royal Eye Hospital.
• Analysis of clinical deterioration, radiological imaging, site of orbital collection, sinus involvement, types of neurological complications, and microbiology findings.

Main Results:

• Nine out of 26 patients developed neurological complications, including subdural empyema, leptomeningeal enhancement, and septic emboli.
• All patients with neurological complications had significant pan-sinusitis at presentation.
• Superior orbital abscess and Streptococcus mileri infection were associated with a higher risk of neurological complications.

Conclusions:

• Early surgical intervention should be considered for patients with chronic sinusitis and orbital cellulitis.
• Patients with orbital cellulitis who do not improve clinically require re-imaging to rule out neurological complications.