Preseptal and Orbital Infections

Wald, Ellen R.

doi:10.1016/b978-0-323-40181-4.00085-2

Cited by 4 publications

(5 citation statements)

References 49 publications

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“…1,2 In contrast, a hordeolum is an acute bacterial infection of the eyelid typically caused by the Staphylococcus genus and is divided between those originating from an eyelash follicle and adjacent glands of Zeis or Moll (external) versus those arising from a meibomian gland (internal). 3 This nomenclature is often used interchangeably despite differing etiologies. They represent the second leading cause of nonemergent, eye-related emergency department visits in the U.S. accounting for more than 100,000 visits a year.…”

mentioning

confidence: 99%

Efficacy of Care and Antibiotic Use for Chalazia and Hordeola

Alsoudi

Ton²,

Ashraf³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objectives: To evaluate whether use of an antibiotic improves the efficacy of care for a chalazion or hordeolum. Methods: A cross-sectional retrospective review was performed. All patients treated for a newly diagnosed chalazion or hordeolum at the University of California, San Francisco from 2012 to 2018 were identified. Patients were excluded when clinical notes were inaccessible or there was inadequate documentation of treatment modality or outcome. Patient demographics, setting of initial presentation, treatment modalities, antibiotic use, and outcomes were analyzed. Results: A total of 2,712 patients met inclusion criteria. Management with an antibiotic was observed in 36.5% of patients. An antibiotic was 1.53 times (95% confidence interval [CI], 1.06-2.22, P¼0.025) more likely to be prescribed in emergency or acute care setting for a chalazion. Older age was associated with a higher risk of receiving an antibiotic for a hordeolum (adjusted RR 1.07 per decade, 95% CI, 1.05-1.11, P,0.001). The addition of an antibiotic to conservative measures for a chalazion (adjusted RR, 0.97, 95% CI, 0.89-1.04, P¼0.393) or hordeolum (adjusted RR, 0.99, 95% CI, 0.96-1.02, P¼0.489) was not associated with an increased likelihood of treatment success. Conclusion: Although frequently prescribed, an antibiotic is unlikely to improve the resolution of a chalazion or hordeolum.

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confidence: 99%

Efficacy of Care and Antibiotic Use for Chalazia and Hordeola

Alsoudi

Ton²,

Ashraf³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…In children with PC, IV antibiotics should be considered for infants and those with signs of serious systemic infection. Because the meninges are susceptible to inoculation in the infant age group, LP should be performed unless the clinical picture precludes meningitis [12]. In our study group, LP was performed in 9.9% of patients, but meningitis was not diagnosed in any subjects.…”

Section: Discussionmentioning

confidence: 86%

“…The pathogenesis is attributable to the venous drainage of the eyelid and surrounding structures. OC occurs when the infection in the sinuses spread to the orbit through the neighborhood or venous spread [6,12].…”

Section: Discussionmentioning

confidence: 99%

“…Among laboratory parameters, regression analysis only revealed that NLR and platelet count were associated with OC. Although in ammatory parameters are elevated in both PC and OC, the absolute levels of acute phase reactants may be helpful in clinical practice [12]. For instance, higher CRP levels were reported to be associated with post-septal disease in a recent study [10].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, only three of the cultures yielded S. anginosus group. Therefore, empirical treatment should cover all these pathogens in children with orbital infections [12].…”

Section: Discussionmentioning

confidence: 99%

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Preseptal and Orbital Cellulitis: Thirteen Years of Experience and a Novel Scoring System (SNIPPED Score) for Differentiation

Yalçınkaya

Tanır

Özdem

et al. 2021

Preprint

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We aimed to evaluate clinical and laboratory characteristics of children with preseptal cellulitis (PC) or orbital cellulitis (OC) and to determine whether easily-accessible parameters could be used to predict OC. The data of children diagnosed with PC or OC between January 2008 and December 2020 were evaluated. Patients aged between 1 month and 18 years who were treated with intravenous antibiotics were included. Logistic regression analysis was performed to identify possible parameters in differentiating between PC and OC. A beta coefficient-based method was used to derive the scoring system. A total of 375 patients [202 (53.9%) boys], of whom 35 (9.3%) had OC, were evaluated. Median age was 44 (min-max: 1-192) months. Compared to those with PC, patients with OC were older (p = 0.001), had fever and upper respiratory tract infection (URTI) symptoms more frequently, and demonstrated prolonged symptom and hospitalization times (p˂0.001 for all). Significant differences between groups were observed for numerous parameters; however, logistic regression analysis revealed only five parameters independently associated with OC. The SNIPPED score variables and weights were as follows: sinusitis (2 points), neutrophil-to-lymphocyte ratio > 6.78 (3 points), platelet count > 420.5 x103/mm3 (2 points), proptosis (4 points) and duration of symptoms ≥ 4 days (4 points). A cut-off of ≥ 7 points for OC diagnosis was found to have 91.4% sensitivity, 96.2% specificity, 71.1% PPV, 99.1% NPV and 95.7% accuracy. Conclusion: In addition to showing previously known properties of OC versus PC, our study demonstrated that easily-accessible parameters could be used for the identification of OC.

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