Recurrent periorbital cellulitis associated with rhinosinusitis in children: Characteristics, course of disease, and management paradigm

Tzelnick, Sharon; Soudry, Ethan; Raveh, Eyal; Gilony, Dror

doi:10.1016/j.ijporl.2019.02.037

Cited by 11 publications

(2 citation statements)

References 17 publications

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“…1 In children, recurrent cellulitis is previously only reported in the context of lymphoedema 30 and periorbital cellulitis associated with rhinosinusitis. 31 Our study demonstrates a high rate of recurrent cellulitis in children without these risk factors, with MRSA common in recurrent cellulitis. More studies are required to examine the risk factors for recurrent cellulitis in children and inform the use of prophylactic antibiotics and prevention strategies.…”

Section: Discussionmentioning

confidence: 60%

Cellulitis in children: a retrospective single centre study from Australia

Salleo

MacKay

Cannon

et al. 2021

bmjpo

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AimTo characterise the epidemiology, clinical features and treatment of paediatric cellulitis.MethodsA retrospective study of children presenting to a paediatric tertiary hospital in Western Australia, Australia in 2018. All inpatient records from 1 January to 31 December 2018 and emergency department presentations from 1 July to 31 December 2018 were screened for inclusion.Results302 episodes of cellulitis were included comprising 206 (68.2%) admitted children and 96 (31.8%) non-admitted children. The median age was 5 years (IQR 2–9), 40 (13.2%) were Aboriginal and 180 (59.6%) boys. The extremities were the most commonly affected body site among admitted and non-admitted patients. There was a greater proportion of facial cellulitis in admitted patients (27.2%) compared with non-admitted patients (5.2%, p<0.01). Wound swab was the most frequent microbiological investigation (133/302, 44.0%), yielding positive cultures in the majority of those tested (109/133, 82.0%). The most frequent organisms identified were Staphylococcus aureus (94/109, 86.2%) (methicillin-susceptible S. aureus (60/94, 63.8%), methicillin-resistant S. aureus) and Streptococcus pyogenes (22/109, 20.2%) with 14 identifying both S. aureus and S. pyogenes. Intravenous flucloxacillin was the preferred antibiotic (154/199, 77.4%), with median intravenous duration 2 days (IQR 2–3), oral 6 days (IQR 5–7) and total 8 days (IQR 7–10).ConclusionsCellulitis is a common reason for presentation to a tertiary paediatric hospital. We confirm a high prevalence of extremity cellulitis and demonstrate that children with facial cellulitis often require admission. Cellulitis disproportionately affected Aboriginal children and children below 5 years. Prevention of cellulitis involves early recognition and treatment of skin infections such as impetigo and scabies.

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Section: Discussionmentioning

confidence: 60%

Cellulitis in children: a retrospective single centre study from Australia

Salleo

MacKay

Cannon

et al. 2021

bmjpo

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“…Rarely, fungi or mycobacteria can cause orbital cellulitis. In any case, this complication is an ocular emergency that requires the collaboration of a medical team including an ophthalmologist, an ENT doctor, a radiologist, and sometimes an infectious disease specialist or a cardiologist [ 14 , 15 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Management of oculo-orbital complications of odontogenic sinusitis in adults

2024

RJO

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Introduction: Odontogenic maxillary sinusitis (OMS) is an infectious inflammatory pathology caused by a dental condition. Considering the anatomical relations with the orbit, maxillary sinus infection can easily spread, evolving into severe oculo-orbital complications that can sometimes be life-threatening. Material and methods: We performed a retrospective study of over 2 years, examining the data of 18 patients diagnosed with OMS with oculo-orbital complications. The patients were evaluated regarding their dental history, symptoms, clinical and endoscopic findings, ophthalmologic evaluation, bacteriologic tests, computed tomography (CT) imaging, medical and surgical treatment, and outcomes. Results: The age of the patients was between 24 and 65 years old with an almost equal gender distribution: 10 female and 8 male patients. From the total, 7 patients had type II diabetes, 2 of whom were insulin-dependent, 1 patient had thrombophilia and 2 patients had renal failure with peritoneal dialysis. Regarding the type of oculo-orbital complications, 10 patients were diagnosed with preseptal cellulitis and 8 with orbital cellulitis. Just 5 patients with orbital cellulitis required surgical treatment and orbitotomy was performed, followed by endonasal endoscopic drainage. The evolution after surgical treatment was favorable for all operated patients. Discussions: Oculo-orbital complications of OMS are typically more severe than those of rhinogenic sinusitis because anaerobic bacteria are involved. Immunosuppression represents a favorable environment for the development of OMS and its complications, diabetes being the most common risk factor. A negative prognostic feature is the appearance of ophthalmological symptoms in both eyes, so visual function may be reduced. The treatment of oculo-orbital complications of OMS is urgent and depends on a broad-spectrum antibiotic therapy associated or not with surgical intervention. Conclusions: The diagnosis of oculo-orbital complications of OMS is complex and requires clinical experience as well as extensive medical knowledge to treat both the cause and the consequences of the conditions quickly and effectively. The proper management of oculo-orbital complications is based on a multidisciplinary team: ophthalmology, ENT, dentistry, imaging, and laboratory. Abbreviations: OMS = odontogenic maxillary sinusitis, CT = computed tomography, ENT = ear-nose-throat, MRI = magnetic resonance imaging, HNS = head and neck surgery

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