Pediatric Preseptal and Orbital Cellulitis: A Comparative Study of Clinical, Radiologic, and Laboratory Features

Area of Science:

• Ophthalmology
• Pediatric Infectious Diseases
• Otorhinolaryngology

Background:

• Preseptal and orbital cellulitis are common pediatric infections.
• Differentiating these conditions is crucial for appropriate management.
• Understanding their distinct clinical, laboratory, and radiologic features is essential.

Purpose of the Study:

• To compare clinical, laboratory, and radiologic characteristics of pediatric preseptal and orbital cellulitis.
• To evaluate and contrast treatment approaches for these two conditions.
• To identify key differences aiding in diagnosis and management.

Main Methods:

• Retrospective, cross-sectional study of pediatric patients from January 2019 to December 2023.
• Analysis of demographic, clinical, etiologic, laboratory, and radiologic data.
• Inclusion of 244 pediatric patients diagnosed with preseptal or orbital cellulitis.

Main Results:

• Preseptal cellulitis (95.5%) was significantly more common than orbital cellulitis (4.5%).
• Orbital cellulitis presented with more frequent fever, proptosis, pain with eye movements, and diplopia.
• Sinusitis was a consistent finding in orbital cellulitis (100%), while conjunctivitis predominated in preseptal cases (28.3%).
• Higher leukocyte and C-reactive protein levels were observed in orbital cellulitis.
• Computed tomography revealed abscesses in a small percentage of cases; 54.5% of orbital cellulitis patients required surgery.
• No permanent complications were noted in either group.

Conclusions:

• Preseptal cellulitis is more prevalent and generally less severe.
• Orbital cellulitis, though rarer, exhibits more severe symptoms and elevated inflammatory markers.
• Radiologic imaging is vital for diagnosis, complementing clinical evaluation.
• The strong association between sinusitis and orbital cellulitis underscores the need for early recognition and management of sinus infections to prevent severe outcomes.