Orbital cellulitis in children: clinical analysis of 16 cases

Orbital cellulitis, defined as eyelid erythema and edema, proptosis and/or ophthalmoplegia, with or without visual acuity loss, is a rare, but severe infectious disease. The medical records were reviewed of 16 children, aged 18 years or under, who were admitted at Chang Gung Memorial Hospital with a diagnosis of orbital cellulitis during the period from January 1977 to June 1993. The 16 children included 13 males and 3 females. The mean age of the patients was 5.6 years. Sinusitis, diagnosed clinically and radiologically in eight cases, was the most common predisposing factor. From pus or blood in five patients, these pathogens were isolated: Staphylococcus aureus (2), viridans streptococci (1) and mixed bacterial flora (2). All of the patients were treated with systemic antibiotics. The mean duration of fever after initiation of antibiotic therapy was 2.9 days. Four patients subsequently developed complications: subperiosteal abscess (2), orbital abscess (1), and bacteremia (1). Five patients received surgical treatment. No mortality was reported. After a follow-up period of 1-2 months, no sequelae were found among any of these 16 patients.