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Differences Between Adult and Pediatric Periorbital Cellulitis Secondary to Acute Rhinosinusitis
John Dewey1, Amani Kais1, John Nguyen2
1Department of Otolaryngology, West Virginia University, Morgantown, USA.
The Annals of Otology, Rhinology, and Laryngology
|June 12, 2025
Summary
Adults with periorbital cellulitis from acute rhinosinusitis (ARS) require more surgery and longer hospital stays than children. Neurological complications are more common in adults, contributing to extended care needs.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Infectious Diseases
Background:
- Periorbital cellulitis is an infection of the eyelid and surrounding tissues.
- Acute rhinosinusitis (ARS) is a common cause of periorbital cellulitis, particularly in pediatric patients.
- Understanding age-related differences in clinical presentation and outcomes is crucial for effective management.
Purpose of the Study:
- To compare clinical characteristics and outcomes of adult versus pediatric patients with periorbital cellulitis secondary to ARS.
- To identify factors associated with disease severity and treatment requirements in different age groups.
Main Methods:
- Retrospective cohort study of 163 patients (80 adults) presenting to an academic medical center emergency department between 2012 and 2022.
- Data collected included medical history, treatment, hospital length of stay (LoS), and readmission rates.
- Multivariate analyses were performed to identify independent predictors of outcomes.
Main Results:
- Adults (mean age 49.2 years) and children (mean age 6.4 years) had similar CT Lund-Mackay scores and rates of postseptal cellulitis.
- Adults were significantly more likely to require surgical treatment (45% vs 21.7%), experience neurological complications (11.3% vs 0%), have longer LoS (6.9 vs 3.6 days), and require 30-day readmission (16.3% vs 6%).
- Multivariate analysis confirmed adult age was independently associated with surgical treatment but not longer LoS.
Conclusions:
- Adults with ARS-related periorbital cellulitis face higher rates of surgical intervention and prolonged hospitalizations compared to pediatric patients.
- Neurological complications may contribute to the increased LoS observed in adult patients.
- Age is a significant factor influencing the management and outcomes of periorbital cellulitis secondary to ARS.
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