Periorbital and Orbital Cellulitis in Children. A retrospective study

Abstract

Background: Periorbital and orbital cellulitis can be a acomplicated disease in children and may lead to vision loss. Sinusitis is a universal predisposing factor, in particular ethmoid sinusitis. External eye infections, trauma and dental abscesses may be contributing factors. Staphylococcus aureus remains an important pathogen, and poses problems particularly with increasing drug resistance. We aim to report the clinical, demographic and microbiological profile of children with periorbital and orbital cellulitis. We also analyzed the risk factors for positive bacterial cultures among children with periorbital and orbital cellulitis from a tertiary care center.

Method: This was a retrospective chart review of children (1 month – 15 years) with a discharge diagnosis of periorbital and orbital cellulitis, from July 2009 to June 2014 in the department of Paediatrics, Aga Khan University Karachi. Clinical and
demographic feature and laboratory data were collected and analyzed. Risk factors of positive blood cultures were also analyzed.

Results: The medical records of 34 children with a discharge diagnosis of orbital or periorbital cellulitis were reviewed. It was found that most of the children (n=18; 53%) were younger than 5 years of age. Most affected were males (n=21; 62%). The left
eye was involved in most of the cases (n=14, 41%). The main presenting complaints included pain, redness around the eyes and fever. Eyelid infection was found to be the most common etiological factor predisposing to periorbital /orbital cellulitis (n=7, 21%). Young age remains the main risk factors for bacterial positivity.

Conclusion: Periorbital and orbital cellulitis are a relatively rare the in children. Periorbital cellulitis if treated well can prevent orbital complications. Staphylococcus aureus is the main pathogen and sinusitis remains the main risk factors. 

Keywords: Periorbital, orbital cellulitis, Children, Sinusitis