Ophthalmology in China

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Clinical diagnosis, treatment and efficacy of 97 cases of pediatric orbital cellulitis

FAN Yun-wei, WU Qian, YU Gang, CAO Wen-hong, WANG Yuan, LIU Wen   

  1. Department of Ophthalmology, National Key Discipline of Pediatrics, Beijing Children Hospital, Capital Medical University, 100045 Beijing, China
  • Received:2015-04-12 Online:2015-11-25 Published:2015-12-03
  • Contact: WU Qian, Email: wuqian526@126.com E-mail:wuqian526@126.com


Objective To investigate the clinical diagnosis, treatment and efficacy of children orbital cellulitis. Design Retrospective case series. Participants 97 cases (106 eyes) of orbital cellulitis in children with age from 7 day after birth to 11-year old (average 11±9 months). Methods All of the patients underwent the following examinations: orbit and paranasal sinus computed tomography (CT), blood routine test, C reactive protein (CRP), blood culture and drug sensitivity. Visual acuity, eye position, anterior segment, fundus examination were examed for cooperative children older than 4 years. All the patients were treated with antibiotic eyedrops, oral or intravenous antibiotics. Indication of incision and drainage: (1) definite diagnosis of preorbital cellulitis; (2) white blood cells (WBC) and CRP much higher than normal; (3) antibiotics cannot control the infection; (4) eyelid swelling and fluctuant feeling of the abscess; (5) support of orbital CT. Germicultures were performed after the incision and drainage. Then clinical manifestations, WBC, CRP, and the efficacy, etiological examination, and complications were observed and analysed. Main Outcome Measures Clinical manifestations, WBC, CRP, and the efficacy, etiological examination, and complications. Results 74 cases (76%) were younger than 3-year old, of which 23 cases were within 1 month after birth. 71 eyes (67%) manifested as preorbital cellulitis and 35 eyes (33%) as orbital cellulitis. 63 eyes (59%) with the indications underwent the operation of incision and drainage on top of using systemic antibiotics. WBC, CRP and body temperature was (23.6±9.1) ×109/L, (52±17) mg/L, and (38.8±1.4) °C before treatment, which decreased to (16.3±5.1)×109/L,(37±12)mg/L,and (38.2±0.4)°C respectively at first day after the drainage. Infection symptoms were completely controlled after removal of the drainage strip 7~10 days postoperatively. Staphylococcus aureus was the most common pathogen (81%). And conjunctival prolapse and exposure keratitis were the most commom complications(27%). Conclusion The incidence of orbital cellulitis often happened in infants. A combination of systemic antibiotic, incision and drainage works well to control the sympotoms of children orbital cellulitis.

Key words: preorbital cellulitis, orbital cellulitis, children