Clinical features and outcome of preseptal and orbital cellulitis in hospitalized children: Four years experience

Demir, Sevliya Öcal

doi:10.5222/mmj.2017.007

Cited by 3 publications

(6 citation statements)

References 14 publications

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“…15,[17][18][19] However, there are also other studies in which the incidence of sinusitis is lower in patients with preseptal cellulitis. 7,16 This is in concordance with our results where all patients with orbital cellulitis were associated with sinusitis. 2 CT is the most useful imaging method in the diagnosis of sinusitis and in evaluating a patient with orbital infection and can also reveal the presence of complications such as orbital abscess and subperiosteal abscess.…”

Section: Discussionsupporting

confidence: 92%

“…15,17–19 However, there are also other studies in which the incidence of sinusitis is lower in patients with preseptal cellulitis. 7,16 This is in concordance with our results where all patients with orbital cellulitis were associated with sinusitis. 2…”

Section: Discussionsupporting

confidence: 92%

“…The need for surgical treatment in subperiosteal abscess has been reported in 14%-23% in various studies. 7,15,16 In our study, 3 patients with orbital subperiosteal abscess (2.4% in the whole patient group and 25% in the orbital cellulitis group) underwent endoscopic drainage due to the need for surgical treatment and 4 patients successfully treated with systemic antibiotics alone. Recurrence of infection occurred rarely.…”

Section: Discussionmentioning

confidence: 70%

“…In studies comparing age distribution of preseptal cellulitis and orbital cellulitis cases, it was reported that the mean age of patients with orbital cellulitis was higher than those with preseptal cellulitis. 2,14,15 In the study of Botting et al, 7 while the mean age distribution in preseptal cellulitis/orbital cellulitis cases was 3.9/7.5 years, it was found to be 4.7/8.1 years in the study of Demir et al 16 Although the exact cause of this age difference is not known, it may be due to the fact that rhinosinusitis is more common in the etiology of orbital cellulitis than preseptal cellulitis and that the aeration of the sinuses in the younger age group is not yet completed.…”

Section: Discussionmentioning

confidence: 92%

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Preseptal and Orbital Cellulitis

Bülbül

Sağlam

Elitok

et al. 2021

Pediatric Infectious Disease Journal

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Background: We aimed to compare the clinical and laboratory characteristics and imaging methods of patients diagnosed with preseptal cellulitis and orbital cellulitis in the pediatric age group. Methods: The study was designed retrospectively, and the medical records of all patients who were hospitalized with the diagnosis of preseptal cellulitis and orbital cellulitis were reviewed. The findings of preseptal cellulitis and orbital cellulitis groups were compared. The risk factors for the development of orbital involvement were analyzed. Results: A total of 123 patients were included, 90.2% with preseptal cellulitis and 9.8% with cellulitis. The male gender ratio was 60.2%, and the mean age was 72 ± 43 months. While all patients had eyelid swelling and redness, 20.3% had fever. Ocular involvement was 51.2% in the right eye and 4.9% in both eyes. The most common predisposing factor was rhinosinusitis (56.1%). Radiologic imaging (computed tomography/magnetic resonance imaging) was performed in 83.7% of the patients. Subperiostal abscess was detected in 7 cases (5.6%) in which three of the cases were managed surgically and four were treated with medically. The levels of C-reactive protein were significantly higher in patients with orbital involvement (P = 0.033), but there was no difference between the presence of fever, leukocyte and platelet values. Conclusions: Rhinosinusitis was the most common predisposing factor in the development of preseptal cellulitis and orbital cellulitis. Orbital involvement was present in 9.8% of the patients. It was determined that high C-reactive protein value could be used to predict orbital involvement.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 92%

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Preseptal and Orbital Cellulitis

Bülbül

Sağlam

Elitok

et al. 2021

Pediatric Infectious Disease Journal

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“…WBC count was significantly higher in patients with groups 2, 3, and 4 than group 1 in two studies (Devrim et al, 12 P < .01; Santos et al, 13 P = .025). CRP was significantly higher in patients with groups 2, 3, and 4 than group 1 in four studies (Öcal Demir et al, 14 P = .02; Devrim et al, 12 P < .01; Ohana‐Sarna‐Cahan et al, 18 P < .001; Santos et al, 13 P < .001). Patients with groups 2, 3, and 4 had a significantly higher fever rate in three studies (Botting et al, 21 P < .001; Ohana‐Sarna‐Cahan et al, 18 P = .0001; Santos et al, 13 P = .029).…”

Section: Resultsmentioning

confidence: 93%

Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Burek

Melamed

Liljestrom

et al. 2021

Journal of Hospital Medicine

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BACKGROUND AND OBJECTIVES: Pediatric orbital cellulitis/abscess (OCA) can lead to vision loss, intracranial extension of infection, or cavernous thrombosis if not treated promptly. No widely recognized guidelines exist for the medical management of OCA. The objective of this review was to summarize existing evidence regarding the role of inflammatory markers in distinguishing disease severity and need for surgery; the role of imaging in OCA evaluation; and the microbiology of OCA over the past 2 decades. METHODS: This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in MEDLINE (Ovid), Web of Science Core Collection, Scopus, CINAHL (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL), most recently on February 9, 2021. RESULTS: A total of 63 studies were included. Most were descriptive and assessed to have poor quality with high risk of bias. The existing publications evaluating inflammatory markers in the diagnosis of OCA have inconsistent results. Computed tomography imaging remains the modality of choice for evaluating orbital infection. The most common organisms recovered from intraoperative cultures are Streptococcus species (Streptococcus anginosus group, group A Streptococcus, and pneumococcus) and Staphylococcus aureus. Methicillin-resistant S aureus in culture-positive cases had a median prevalence of 3% (interquartile range, 0%-13%). CONCLUSION: This systematic review summarizes existing literature concerning inflammatory markers, imaging, and microbiology for OCA evaluation and management. High-quality evidence is still needed to define the optimal medical management of OCA.

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Pre-septal and Orbital Cellulitis: A Retrospective Analysis of Manifestations and Outcomes of a Tertiary Center in Kuwait

Hayat,

Al-Musalam,

Al-Shaya

et al. 2024

Cureus

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Introduction Orbital cellulitis is an infectious condition that presents a gap in the literature in regard to its manifestations in the Middle East. A retrospective investigation was undertaken at one tertiary care facility in Kuwait, aiming to augment regional insights into the etiological factors and subsequent outcomes associated with this condition. Methods A retrospective review collected data from 92 patients in a tertiary care center in Kuwait for patients admitted with pre-septal and orbital cellulitis between January 2013 and June 2023. Primary outcomes assessed the resolution of symptoms, categorized as "completely resolved" and "resolved with complications". Secondary outcome measures included patients’ ages, microbiology, laboratory, and radiological findings. Gender, predisposing conditions, surgical status, and orbital involvement were additionally extracted and analyzed descriptively. Results Data of n=92 (56 males and 36 females) were extracted. Ages ranged from 20 days to 18 years, the mean being seven years. Additionally, 52.2% (n=48) were diagnosed with orbital cellulitis, and 42.4% (n=39) were diagnosed with pre-septal cellulitis on admission. Cultures were available for n=60. Specifically, 52.1% (n=48) received CT scans; 6.5% (n=6) MRI scans; and 98.9% (n=91) received antibiotics (microbiology investigated: n=83). Ceftriaxone was used in 82.6% (n=76); 20.6% (n=19) received surgical interventions, and incision and drainage (I&D) were done on 15.2% (n=14). Visual acuity was assessed in 59.7% (n=55) patients. Five (5.43%) reported visual deterioration, and 87 (94.6%) of the outcomes were classified as “completely resolved”. Conclusion Upper respiratory tract infections were the most common documented predisposing risk factor in the development of pre-septal and orbital cellulitis. Adverse outcomes in vision were documented in 5.43% of patients. A paucity of regional data highlights the importance of conducting further studies locally.

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Clinical features and outcome of preseptal and orbital cellulitis in hospitalized children: Four years experience

Cited by 3 publications

References 14 publications

Preseptal and Orbital Cellulitis

Preseptal and Orbital Cellulitis

Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Pre-septal and Orbital Cellulitis: A Retrospective Analysis of Manifestations and Outcomes of a Tertiary Center in Kuwait

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