Microbiology and antibiotic therapy of subperiosteal orbital abscess in children with acute ethmoiditis

Coudert, Aurélie; Ayari-Khalfallah, S.; Suy, Paul; Truy, Éric

doi:10.1016/j.ijporl.2018.01.021

Cited by 42 publications

(33 citation statements)

References 30 publications

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“…Over the past decades, anaerobic bacteria emerged in head and neck infections, such as mastoiditis and ethmoiditis . F necrophorum now represents one of the most frequent anaerobic pathogen in otogenic infection.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past decades, anaerobic bacteria emerged in head and neck infections, such as mastoiditis and ethmoiditis. 1,7 F necrophorum now represents one of the most frequent anaerobic pathogen in otogenic infection. This increase is not fully clarified but it is probably TA B L E 1 Comparison of biological, radiological and therapeutic data between the "OLST Fusobacterium group" and the "OLST other bacteria group"…”

Section: Fusobacterium Necrophorum: An Emerging Pathogenmentioning

confidence: 99%

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Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Coudert

Fanchette

Regnier

et al. 2019

Clinical Otolaryngology

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Objective To evaluate in children the clinical severity and evolution of otogenic lateral sinus thrombosis (OLST) due to Fusobacterium necrophorum compared with other bacterial otogenic thrombosis and propose a specific management flowchart for Fusobacterium OLST. Design A retrospective multicentre cohort study. Settings Four French ENT paediatric departments. Participants A total of 260 under 18 years old admitted for acute mastoiditis were included. Initial imaging was reviewed to focus on complicated mastoiditis and 52 OLST were identified. Children were then divided into two groups according to bacteriological results: 28 in the “OLST Fusobacterium group” and 24 in the “OLST other bacteria group”. Results There was a significant association between F necrophorum and OLST (P < .001). When compared to the OLST other bacteria group, children in the OLST Fusobacterium group were significantly younger (61 months vs 23 months, P < .01) and had a more severe clinical presentation: higher CRP (113 mg/L vs 175.7 mg/L, P = .02) and larger subperiosteal abscess (14 mm vs 21 mm, P < .01). Medical management was also more intensive in the OLST Fusobacterium group than in the OLST other bacteria group: increased number of conservative surgeries (66.7% vs 92.9%, P = .03) and longer hospital stay (13.7 days vs 19.8 days, P = .02). At the end of follow‐up, the clinical course was good in both groups without any neurological sequelae. Conclusions Thrombotic complications are very frequent in case of Fusobacterium mastoiditis and clinicians should be aware of the initial severity of the clinical presentation. Under appropriate management, the clinical course of Fusobacterium OLST is as good as that of other bacterial otogenic thrombosis.

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Section: Discussionmentioning

confidence: 99%

Section: Fusobacterium Necrophorum: An Emerging Pathogenmentioning

confidence: 99%

Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Coudert

Fanchette

Regnier

et al. 2019

Clinical Otolaryngology

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“…The initial medical treatment consists of intravenous antibiotics that cover the most widely involved pathogens and provide adequate penetration of the central nervous system in order to decrease the risk of intracranial diffusion. These schedules include clindamycin plus third-generation cephalosporin, vancomycin with or without meropenem, ampicillin-sulbactam, and third-generation cephalosporin plus metronidazole [13,14,34,35,36].…”

Section: Treatmentmentioning

confidence: 99%

Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview

Torretta

Guastella

Marchisio

et al. 2019

JCM

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Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians.

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“…28 The most common microorganism responsible for complicated ethmoiditis in the pediatric population is S. aureus, followed by Streptococcus spp. 6,29 In the current study, the most frequently cultured bacteria were Streptococcus spp. and S. aureus.…”

Section: Discussionmentioning

confidence: 52%

Management of Orbital Complications of Acute Rhinosinusitis in Pediatric Patients

Trivić

Çevik

Folić³

et al. 2019

Pediatric Infectious Disease Journal

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Background: The major clinical dilemma managing acute rhinosinusitis (ARS) in pediatric population is distinguishing uncomplicated rhinosinusitis from a complicated bacterial ARS and orbital complications, the latter requiring antimicrobials and surgical intervention. However, factors associated with severe orbital complications and the optimum management strategy remains controversial. The objectives of this study were to characterize the clinical outcomes of children with orbital complications of ARS and to identify risk factors associated with disease severity. Methods: This retrospective cohort analysis evaluated the clinical outcomes of 61 children admitted for orbital complications between 1 st January 2002 and 31 st December 2017. Descriptive statistics were performed to examine the demographics and clinical findings. We compared groups using Mann-Whitney test for continuous variables and Chi-square for categorical variables. Results: Although two-thirds of children had received pre-hospital antibiotics, half of the cohort presented with post-septal orbital complications. While 83% of isolates obtained from the same patients were susceptible to the pre-hospital antibiotics given, the majority of those who received pre-hospital antibiotics nevertheless required surgical intervention. We observed significant association between the age of presentation and disease severity. Children older than 5 years of age presented with more severe orbital complications despite pre-hospital antibiotics and were more likely to require surgical intervention (p<0.001). Conclusion: In this study, stage II/III orbital complications at presentation and older age were the most important determinants of medical treatment failure. Early referral to ENT should be considered for children >5 years with ARS due to worse orbital complications despite pre-hospital antibiotics. * According to Chi-square test, p<0.05 ** According to Mann-Whitney U test, p<0.05

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Microbiology and antibiotic therapy of subperiosteal orbital abscess in children with acute ethmoiditis

Cited by 42 publications

References 30 publications

Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study

Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview

Management of Orbital Complications of Acute Rhinosinusitis in Pediatric Patients

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