Common orbital infections ~ State of the art ~ Part I

Turk pediatri arsivi, 2017

Orbital tissue infections are common infections of childhood that can lead to severe complications. Herein, we aimed to evaluate the etiologic factors, diagnosis, follow-up, and treatment procedures in pediatric patients with orbital infections. This study was performed retrospectively between January 2014 and December 2015 in Cerrahpasa Medical Faculty Pediatric Infectious Disease Unit. Patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities, and the response to these treatments. Thirty-six patients (21 males, 15 females) with an average age of 71.43±42.24 months (5-168 months) participated in the study in the two-year period. Thirty-two patients (88.9%) had preseptal cellulitis, and four (11.9%) had orbital cellulitis. All patients had eyelid hyperemia, edema, and ocular pain, with chemosis in seven and proptosis in four cases. Twenty-five patients were admitted with fever. All cases were unilateral and 44.4% occur...

Current Opinion in Ophthalmology, 2001

Infections of the orbit and periorbital tissues are not uncommon. Trauma, skin infections, and sinusitis are frequently the underlying cause. Studies have shown changes in epidemiology and pathogens in the last decade. Although classical manifestations are usually present, atypical cases without specific signs and symptoms may confound the diagnosis. A high index of suspicion, aided by ultrasonography, computed tomography, and magnetic resonance imaging, is frequently required for an accurate diagnosis. Prompt diagnosis and treatment may lead to resolution of the infection, thus avoiding ocular sequelae. Orbital infections may spread into the globe, causing endophthalmitis. Some patients may even need an enucleation or evisceration. New materials and techniques may improve the final result of an anophthalmic socket.

Journal of Ophthalmic Inflammation and Infection

Background: Orbital cellulitis is an ophthalmic emergency, which is associated with vision-threatening adverse effects. The purpose of this study is investigating etiology, radiologic findings, management and complications of patients with non-medial orbital cellulitis. Method: A retrospective medical record and radiologic file review of patients with infectious orbital cellulitis was performed to detect all patients with non-medial orbital cellulitis who referred to Khalili hospital from 2016 to 2019. Age, sex, origin of infection, size of collection or abscess, medical or surgical management, microbiology, first and final best-corrected visual acuity, duration of admission, and complications was recorded. Patients divided into two groups; medical management and surgical management groups and all of data compared between in this groups. Results: Of ninety-six patients with infectious orbital cellulitis, 23 cases (14 male, 9 female) were included. Five patients (21.7%) were managed medically and 18 patients (78.3%) were managed surgically. Patients' age range was 5-70 years old. Most common location for non-medial cellulitis was superior space (66.7% in surgical and 40% in medical group; p = 0.511). In 13 cases of surgical group (72.3%) were detected microorganisms. The mean ± SD of collection volume in medical group were 476.5 ± 290.93 mm 3 and 2572.94 ± 1075.75 mm 3 in surgical group (p < 0.001). Ten patients in surgical group had compressive optic neuropathy. The mean ± SD of collection volume was 3204.97 ± 879.88 mm 3 in patient with compressive optic neuropathy and 1280.43 ± 880.68 mm 3 in patient without compressive optic neuropathy (P < 0.001). One case complicated by subdural empyema and another case progressed to necrotizing fasciitis. Conclusion: Non-medial orbital cellulitis is an uncommon but sight-threatening and life-threatening condition. Timely diagnosis and accurate management reduce morbidity and mortality. Combined surgery for patients with superior or supra-temporal and large non-medial abscess is recommended.

PEDIATRICS, 2011

American Journal of Ophthalmology, 2007

PURPOSE: To evaluate the microbiology of pediatric orbital cellulitis associated with sinusitis. • DESIGN: Retrospective review of medical records of pediatric patients treated for orbital cellulitis. • METHODS: All pediatric patients treated for orbital cellulitis associated with sinusitis at Texas Children's Hospital between December 1, 2001 and September 30, 2005 were reviewed. Data collected included patient age, history, microbiology results, and surgical intervention. • RESULTS: Thirty-eight cases were identified. Fifteen cases required medical management, whereas 23 patients received a combination of medical and surgical intervention. Three patients had multiple surgical procedures performed. Of the procedures performed, four were sinus irrigation, 12 were sinusotomy and drainage, nine were orbitotomy with drainage of abscess, and one was craniotomy with drainage of abscess. Surgical aspirate specimens yielded a higher positive culture result rate with 9/9 of orbital abscesses and 13/16 of sinus aspirates demonstrating a positive yield. Two of the 27 blood cultures had a positive yield. Staphylococcus species was the most common organism isolated. Methicillin-resistant S. aureus (MRSA) represented 73% of S. aureus isolates. Streptococcus species was the next most common pathogen. Three cultures yielded Haemophilus species with one being positive for H. influenzae. • CONCLUSIONS: Organisms responsible for causing pediatric orbital cellulitis are evolving, with Staphylococcus followed by Streptococcus species being the most common pathogens. The occurrence of MRSA in pediatric orbital cellulitis is increasing, and empiric antimicrobial therapy should be directed against these organisms if they are prevalent in the community. Sinus and orbital abscess aspirates yielded the greatest number of positive cultures, though these invasive surgical procedures should be performed only when clinically indicated. (Am J Ophthalmol 2007;144:497-501.

IP Innovative Publication Pvt. Ltd., 2019

Introduction: Infection in the orbit and the periorbital tissues are particularly important subsets of inflammatory diseases not only because of frequency of presentation but also because of life threatening conditions which demand prompt, specific and therapeutic management. Of the orbital inflammation with infections most common aetiological factors encountered, are due to bacteria. Materials and Methods: All patients with orbital signs and symptoms of inflammatory diseases of infectious origin were selected. Progression, symptoms, history of associated symptoms such as headache, fever, allergy etc. asked for. History of trauma, immunization and systemic illness, endocrinological disorders, infections of any systems and any dermatological disorders were taken into account. Local examination, ENT examination, laboratory and radiological investigations were done in all cases. Results: Incidence of orbital infection is 0.34%. Male preponderance and maximum number of patients were adult. The maximum aetiological factor of orbital infection being due to infections of the ocular adnexae, sinusitis, dacryocystitis, post-surgical, and trauma. Raised IOP in 24%, proptosis in 34%, restricted ocular motility in 42%, mechanical ptosis in 70%, NLD block in 18%, Corneal oedema or opacity in 14% and inflammation of ocular adnexae in almost all cases. In majority of the cases the organism responsible is Pseudomonas aeuroginosa, then staphylococcus aureus. Conclusion: Orbital infection is sight threatening and the pathognomic features and virulence of the causative organism is unpredictable. Early presentation appropriate diagnosis and judicious protocol if followed at an early stage would halt the morbidity and fatality. Keywords: Clinicopathology, Infectious origin, Orbital cellulitis, Orbital inflammation, Preseptal cellulitis

2018

Orbital cellulites is an uncommon infectious process in which patient may present with pain, reduced visual acuity, compromised ocular motility and significant proptosis. [1][3] In the modern era of relatively early access to the health care facilities, complete loss of vi‐ sion from orbital cellulitis is rare. In the vast majority of cases, a history of upper respirato‐ ry tract infection prior to the onset is very common especially in children. [4], [5] Chandler et al, [6] for simplicity has classified the disease into 5 categories and emphasized the pos‐ sibility of fatal outcome due to the extension of the abscess to cavernous sinus in the form of thrombosis and intracranial spread. In addition to the loss of vision, orbital cellulitis can be associated with a number of other serious complications that may include intracranial complications in the form of cavernous sinus thrombosis, meningitis, frontal abscess and even death. Historically, since the wide spread use of effective ...

Common Eye Infections, 2013

Journal of Oral and Maxillofacial Surgery, 1992

European Journal of Ophthalmology, 2010

Purpose Periorbital cellulitis is often difficult to distinguish from orbital cellulitis, which is a potentially lethal infection involving the contents of the orbit. A delay in diagnosis and appropriate treatment may result in serious complications. We studied the predisposing factors, microbiologic data, clinical features, complications, and treatment of periorbital and orbital cellulitis in childhood. Methods Eighty-three medical records of patients (mean age 3.7±3.1 years) admitted to the Department of Pediatrics with a diagnosis of periorbital or orbital cellulitis during the 10-year period January 1997 to December 2007 were retrospectively studied. Results In this series, periorbital cellulitis occurred more frequently (83%) than orbital cellulitis (17%). Of the children with periorbital cellulitis, 85% were younger than 5 years of age, while 62% of the children with orbital cellulitis were older than 5 years of age. The most common predisposing factors in periorbital cellulit...