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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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| Published in: | Journal of paediatrics and child health 2021-02, Vol.57 (2), p.227-233 |
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| container_issue | 2 |
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| container_title | Journal of paediatrics and child health |
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| creator | Murphy, Declan C Meghji, Sheneen Alfiky, Mohamed Bath, Andrew P |
| description | 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 = |
| doi_str_mv | 10.1111/jpc.15179 |
| format | article |
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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 = <0.001).
Conclusion
Multidisciplinary involvement and early medical management can improve outcomes for most patients. Those who deteriorate despite medical management should be considered for prompt imaging and surgical management to avoid serious life‐threatening or sight‐threatening complications.</description><identifier>ISSN: 1034-4810</identifier><identifier>EISSN: 1440-1754</identifier><identifier>DOI: 10.1111/jpc.15179</identifier><identifier>PMID: 32987452</identifier><language>eng</language><publisher>Australia: John Wiley & Sons Australia, Ltd</publisher><subject>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</subject><ispartof>Journal of paediatrics and child health, 2021-02, Vol.57 (2), p.227-233</ispartof><rights>2020 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).</rights><rights>2020 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3889-a2f227cee18feb8d6f1f75c090df92abc6f69259435c35475de316924b08f0963</citedby><cites>FETCH-LOGICAL-c3889-a2f227cee18feb8d6f1f75c090df92abc6f69259435c35475de316924b08f0963</cites><orcidid>0000-0001-9295-7712</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32987452$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murphy, Declan C</creatorcontrib><creatorcontrib>Meghji, Sheneen</creatorcontrib><creatorcontrib>Alfiky, Mohamed</creatorcontrib><creatorcontrib>Bath, Andrew P</creatorcontrib><title>Paediatric periorbital cellulitis: A 10‐year retrospective case series review</title><title>Journal of paediatrics and child health</title><addtitle>J Paediatr Child Health</addtitle><description>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 = <0.001).
Conclusion
Multidisciplinary involvement and early medical management can improve outcomes for most patients. Those who deteriorate despite medical management should be considered for prompt imaging and surgical management to avoid serious life‐threatening or sight‐threatening complications.</description><subject>Abscess</subject><subject>Abscesses</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Cellulitis</subject><subject>Cellulitis - diagnosis</subject><subject>Cellulitis - therapy</subject><subject>Child</subject><subject>Eyelid Diseases</subject><subject>Humans</subject><subject>Medical diagnosis</subject><subject>orbital abscess</subject><subject>orbital cellulitis</subject><subject>Orbital Cellulitis - drug therapy</subject><subject>Orbital Cellulitis - therapy</subject><subject>Pediatrics</subject><subject>periorbital cellulitis</subject><subject>periorbital infection</subject><subject>pre‐septal cellulitis</subject><subject>Retrospective Studies</subject><subject>subperiosteal abscess</subject><issn>1034-4810</issn><issn>1440-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kEtOwzAQhi0EoqWw4AIoEhtYpLUdu7HZVRVPVWoXsI4cZyy5SptgJ6264wickZPgPmCBxGxmNPPNr5kfoUuC-yTEYF7rPuEklUeoSxjDMUk5Ow41TljMBMEddOb9HGNMORenqJNQKVLGaRdNZwoKqxpndVSDs5XLbaPKSENZtqVtrL-LRhHBXx-fG1AuctC4ytegG7uCSCsPkQ9r4MNkZWF9jk6MKj1cHHIPvT3cv46f4sn08Xk8msQ6EULGihpKUw1AhIFcFENDTMo1lrgwkqpcD81QUi5ZwnXCWcoLSEjosBwLg-Uw6aGbvW7tqvcWfJMtrN8erZZQtT6jjKUJYXKHXv9B51XrluG6QEmcYkrFlrrdUzr85x2YrHZ2odwmIzjbupwFl7Ody4G9Oii2-QKKX_LH1gAM9sDalrD5Xyl7mY33kt8614Yl</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Murphy, Declan C</creator><creator>Meghji, Sheneen</creator><creator>Alfiky, Mohamed</creator><creator>Bath, Andrew P</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9295-7712</orcidid></search><sort><creationdate>202102</creationdate><title>Paediatric periorbital cellulitis: A 10‐year retrospective case series review</title><author>Murphy, Declan C ; Meghji, Sheneen ; Alfiky, Mohamed ; Bath, Andrew P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3889-a2f227cee18feb8d6f1f75c090df92abc6f69259435c35475de316924b08f0963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abscess</topic><topic>Abscesses</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Cellulitis</topic><topic>Cellulitis - diagnosis</topic><topic>Cellulitis - therapy</topic><topic>Child</topic><topic>Eyelid Diseases</topic><topic>Humans</topic><topic>Medical diagnosis</topic><topic>orbital abscess</topic><topic>orbital cellulitis</topic><topic>Orbital Cellulitis - drug therapy</topic><topic>Orbital Cellulitis - therapy</topic><topic>Pediatrics</topic><topic>periorbital cellulitis</topic><topic>periorbital infection</topic><topic>pre‐septal cellulitis</topic><topic>Retrospective Studies</topic><topic>subperiosteal abscess</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murphy, Declan C</creatorcontrib><creatorcontrib>Meghji, Sheneen</creatorcontrib><creatorcontrib>Alfiky, Mohamed</creatorcontrib><creatorcontrib>Bath, Andrew P</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of paediatrics and child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murphy, Declan C</au><au>Meghji, Sheneen</au><au>Alfiky, Mohamed</au><au>Bath, Andrew P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paediatric periorbital cellulitis: A 10‐year retrospective case series review</atitle><jtitle>Journal of paediatrics and child health</jtitle><addtitle>J Paediatr Child Health</addtitle><date>2021-02</date><risdate>2021</risdate><volume>57</volume><issue>2</issue><spage>227</spage><epage>233</epage><pages>227-233</pages><issn>1034-4810</issn><eissn>1440-1754</eissn><abstract>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 = <0.001).
Conclusion
Multidisciplinary involvement and early medical management can improve outcomes for most patients. Those who deteriorate despite medical management should be considered for prompt imaging and surgical management to avoid serious life‐threatening or sight‐threatening complications.</abstract><cop>Australia</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32987452</pmid><doi>10.1111/jpc.15179</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9295-7712</orcidid><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Paediatric periorbital cellulitis: A 10‐year retrospective case series review |
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