Bacterial infections of the orbital and periorbital soft-tissues in children

Periorbital soft-tissue bacterial infections are relatively common during childhood and with appropriate antimicrobial therapy usually resolve quickly. Orbital soft-tissue infections, in contrast, are rare and frequently cause serious morbidity. Two hundred forty-one children with periorbital or orbital soft-tissue infections have been hospitalized since 1962 and constitute the data base for this study. Two hundred twenty-six children, half under 1 year of age, had periorbital soft-tissue infections. Response to antimicrobials was prompt and only two children (1%) developed complications. True orbital infections occurred in the remaining 15 children, three of whom were under 6 years of age. Eleven children had orbital cellulitis, 3 had subperiosteal abscesses, and 1 had cavernous sinus thrombosis. Antecedent sinusitis was present in 12 cases and, in seven, effective treatment required surgical drainage in addition to intensive antimicrobial therapy. Three children (20%) developed significant complications.