A swollen right eye in a child

Harris, Mark S; Chawdhary, Gaurav

doi:10.1136/bmj.h554

Cited by 1 publication

(5 citation statements)

References 8 publications

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“…[ 20 ] The most common causes are streptococci ( S. pneumoniae , S. pyogenes ), S. aureus , S. epidermidis , M. catarrhalis , and HIB. [ 6 22 ] Our intraoperative specimens revealed S. pyogenes and anaerobes ( Peptostreptococcus ) as important agents, which have been noted previously. [ 3 22 ]…”

Section: Discussionsupporting

confidence: 70%

“…Surgical treatment involves abscess drainage and ethmoidectomy, endoscopically or by extrinsic orbitotomy. [ 6 14 19 ] It is required in 13% (range 10%–23%) of pediatric cases and is related to older age, as found in present study; conservative management could be efficient in younger patients (aged <9 years) including in cases of subperiosteal abscess. [ 7 9 19 26 – 30 ]…”

Section: Discussionmentioning

confidence: 54%

“…[ 14 15 ] Pre-septal (usually referred as periorbital) cellulitis is an inflammation of the eyelids and soft tissues of the eye anterior to the orbital septum, whereas post-septal (orbital) cellulitis is an inflammation of the orbital tissue posterior to the orbital septum. [ 5 6 14 ] They both have similar initial clinical presentation and are usually unilaterally opposed to eyelid edema and/or erythema provoked by allergic reactions, which are usually bilateral except in some cases of allergic contact dermatitis. [ 1 16 17 ] Periorbital cellulitis occurs more commonly in children under the age of five without gender predominance, whereas orbital cellulitis occurs in older children (mean age of seven years) and is twice as common in boys.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 18 22 26 34 ] Abscess formation (or in some cases, sinusitis and dental infections) necessitates further anaerobic cover. [ 6 24 32 ] Patients in our study were mostly treated with ceftriaxone, whereas half of the patients acquired more than one antimicrobial agent. None of our patients received steroids, as literature data are not consistent.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 – 5 ] A multidisciplinary approach has been proposed to improve diagnosis and clinical outcomes, especially in severe cases, and is usually warranted under the care of pediatricians, otolaryngologists, and ophthalmologists. [ 6 – 9 ] The purpose of this study was to investigate our interdisciplinary management and clinical profile of pediatric pre-septal and pos-tseptal cellulitis.…”

mentioning

confidence: 99%

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Interdisciplinary care in orbital complications of acute rhinosinusitis in children

Trbojević

Penezić

Sitaš

et al. 2022

Indian Journal of Ophthalmology

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Purpose: Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis. Methods: A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020. Results: A total of 26 children—median age 2.7 years (range 0.5–12)—were treated during the study period. Disease presentation was unilateral, mainly during winter ( n = 12) and autumn ( n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis ( P < 0.001), required surgery ( P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1–12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented. Conclusion: Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.

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