Paediatric periorbital cellulitis: A 10‐year retrospective case series review

Aim To identify the predictors of poor outcome and need for surgical management in paediatric patients with periorbital cellulitis. To assess the adherence to local guidelines in the management of periorbital cellulitis. Methods Retrospective descriptive analysis of clinical, laboratory and radiolog...

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Bibliographic Details
Published in:Journal of paediatrics and child health 2021-02, Vol.57 (2), p.227-233
Main Authors: Murphy, Declan C, Meghji, Sheneen, Alfiky, Mohamed, Bath, Andrew P
Format: Article
Language:English
Subjects:
Abscess
Abscesses
Anti-Bacterial Agents - therapeutic use
Cellulitis
Cellulitis - diagnosis
Cellulitis - therapy
Child
Eyelid Diseases
Humans
Medical diagnosis
orbital abscess
orbital cellulitis
Orbital Cellulitis - drug therapy
Orbital Cellulitis - therapy
Pediatrics
periorbital cellulitis
periorbital infection
pre‐septal cellulitis
Retrospective Studies
subperiosteal abscess
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Summary:Aim To identify the predictors of poor outcome and need for surgical management in paediatric patients with periorbital cellulitis. To assess the adherence to local guidelines in the management of periorbital cellulitis. Methods Retrospective descriptive analysis of clinical, laboratory and radiological characteristics of 175 paediatric periorbital cellulitis presentations at a UK teaching hospital over a 10‐year period. Regression investigated correlations for continuous and categorical variables. Results A total of 175 paediatric presentations were diagnosed as periorbital infections over the 10‐year period. Of these, 139 had pre‐septal cellulitis, 27 had a subperiosteal abscess, 6 had an orbital cellulitis, 1 had an orbital abscess, 1 a cavernous sinus thrombosis and 1 an extradural abscess. Median age at presentation was 5 years (range: 1 month–17 years). In total, 169 (97%) cases received systemic antimicrobial treatment. Cross‐sectional imaging occurred in 30% of cases and 18% required surgical intervention. Increasing C‐reactive protein was associated with greater risk of post‐septal disease and requiring surgery. The best predictors of post‐septal disease in the multivariate analysis (R2 = 0.49, P = ≤0.001) were ophthalmoplegia (P = 0.009), proptosis (P = 0.016) and pain on eye movement (P = 0.046). Proptosis was the single most significant predictor of surgical management (R2 = 0.53, P = 
ISSN:1034-4810
1440-1754
DOI:10.1111/jpc.15179