SpringerLink
Log in

Orbital Cellulitis in a Pediatric Population - Experience From a Tertiary Center

  • Research Paper
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To describe our experience in treating children afflicted with orbital cellulitis.

Methods

A retrospective analysis of hospital records of children afflicted with orbital cellulitis was conducted between 2005–2018. Clinical, laboratory and radiology characteristics as well as management, microbiological data, and outcomes were collected.

Results

Of the 94 patients, painful restriction of ocular motility was observed in 37.2% and proptosis in 34%, whereas, only 18% of the children presented with both classical signs. Children aged older than 9 years presented with markedly elevated inflammatory markers i.e., leukocytosis and C-reactive protein (CRP). Only a minority (12, 12.4%) required functional endoscopic sinus surgery.

Conclusion

Our data support the general approach that orbital cellulitis should be initially managed conservatively with close monitoring; since, only a minority of patients require surgical intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Seltz LB, Smith J, Durairaj VD, Enzenauer R, Todd J. Microbiology and antibiotic management of orbital cellulitis, Pediatrics. 2011;127:e566–72.

    Article  Google Scholar 

  2. Garcia G, Harris GJ. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988–1998, Ophthalmology. 2000:107:1454–6.

    Article  CAS  Google Scholar 

  3. Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases. A retrospective review of 262 cases, Int J Pediatr Otorhinolaryngol. 2008;72:377–83.

    Article  CAS  Google Scholar 

  4. Wong SJ, Levi J. Management of pediatric orbital cellulitis: A systematic review. Int J Pediatr Otorhinolaryngol. 2018;110: 123–9.

    Article  Google Scholar 

  5. Ambati BK, Ambati J, Azar N, Stratton L, Schmidt EV. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination, Ophthalmology. 2000;107:1450–3.

    Article  CAS  Google Scholar 

  6. Mahalingam-Dhingra A, Lander L, Preciado DA, Taylormoore J, Shah RK. Orbital and periorbital infections: a national perspective, Arch Otolaryngol Head Neck Surg. 2011;137: 769–73.

    Article  Google Scholar 

  7. Sciarretta V, Demattè M, Farneti P, et al. Management of orbital cellulitis and subperiosteal orbital abscess in pediatric patients: A ten-year review. Int J Pediatr Otorhinolaryngol. 2017;96:72–76.

    Article  Google Scholar 

  8. Rudloe TF, Harper MB, Prabhu PR, Rahbar R, Vanderveen D. Acute periorbital infections: who needs emergent imaging? Pediatrics. 2010;125:e719–e26.

    Article  Google Scholar 

  9. Givner LB. Periorbital versus orbital cellulitis. Pediatr Infect Dis J. 2002;21:1157–8.

    Article  Google Scholar 

  10. Mathew AV, Craig E, Al-Mahmoud R, et al. Paediatric post-septal and pre-septal cellulitis: 10 years’ experience at a tertiary-level children’s hospital. Br J Radiol. 2014;87: 20130503.

    Article  CAS  Google Scholar 

  11. Markham JL, Hall M, Bettenhausen JL, et al. Variation in care and clinical outcomes in children hospitalized with orbital cellulitis, Hosp Pediatr. 2018;8:28–35.

    Article  Google Scholar 

  12. Howe L, Jones NS. Guidelines for the management of periorbital cellulitis/abscess. Clin Otolaryngol Allied Sci. 2004;29:725–8.

    Article  CAS  Google Scholar 

  13. Peña MT, Preciado D, Orestes M, Choi S. Orbital complications of acute sinusitis: Changes in the post-pneumococcal vaccine era. JAMA Otolaryngol Head Neck Surg. 2013;139:223–7.

    Article  Google Scholar 

  14. Al-Nammari S, Roberton B, Ferguson C. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Should a child with preseptal periorbital cellulitis be treated with intravenous or oral antibiotics? Emerg Med J. 2007;24:128–9.

    Article  Google Scholar 

  15. Brown CL, Graham SM, Griffin MC, et al. Pediatric medial subperiosteal orbital abscess: medical management where possible. Am J Rhinol. 2004;18:321–7.

    Article  Google Scholar 

  16. Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthal-mology. 1994;101:585–95.

    Article  CAS  Google Scholar 

  17. Raj C, Lim-Joon T. A complicated case of orbital cellulitis: When the fog doesn’t clear. J Paediatr Child Health. 2015;51: 552–4.

    Article  Google Scholar 

  18. Sinclair CF, Berkowitz RG. Prior antibiotic therapy for acute sinusitis in children and the development of subperiosteal orbital abscess. Int J Pediatr Otorhino-laryngol. 2007;71: 1003–6.

    Article  Google Scholar 

Download references

Acknowledgement

Mrs. Phyllis Curchack Kornspan for her editorial services.

Funding

Funding: None

Author information

Authors and Affiliations

  1. Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel

    Noa Tal Shifman, Irit Krause & Efraim Bilavsky

  2. Ophthalmology Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel

    Gad Dotan

  3. Otolaryngology (Ear, Nose and Throat) Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel

    Dror Gilony

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Noa Tal Shifman, Irit Krause, Gad Dotan, Dror Gilony & Efraim Bilavsky

Authors
  1. Noa Tal Shifman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Irit Krause
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gad Dotan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dror Gilony
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Efraim Bilavsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Contributors: NTS, EB: participated in the conception and design of study and the drafting of manuscript; NTS: participated in the acquisition, analysis and interpretation of the data; IK, GD, DG: participated in the critical revision of manuscript. All authors approved its final version.

Corresponding author

Correspondence to Noa Tal Shifman.

Ethics declarations

Ethics clearance: Institutional Helsinki committee and institutional review board; No. RMC 0578-18m dated Aug 5, 2021.

Competing interest: None stated.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shifman, N.T., Krause, I., Dotan, G. et al. Orbital Cellulitis in a Pediatric Population - Experience From a Tertiary Center. Indian Pediatr 59, 35–37 (2022). https://doi.org/10.1007/s13312-022-2417-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-022-2417-5

Keywords

Search

Navigation