Abstract
Orbital cellulitis is an infection involving the orbit and adjacent periorbital tissue without involvement of other facial tissues. The bacterial etiology, in contrast to that of facial cellulitis, has not been clearly defined. To gain insight into this problem, bacteriological and clinical data on 86 children with orbital cellulitis were reviewed. Peak age incidence was 2-4 yrs. and in 84/86 cases the involvement was unilateral. Differences in clinical presentation enabled identification of two distinct groups. Group I consisted of 42 children with an adjacent soft tissue focus of infection and included 30 children with recent trauma to the area. Group II included 44 patients with no apparent focus of infection. Blood cultures obtained on 21 patients in Group I were positive in only one; the isolate was S. aureus. In Group II, 10/31 blood cultures were positive; 8 isolates were H. influenzae and 2 were S. aureus. The difference in incidence of bacteremia was significant (p< 0.02). S. aureus and/or Group A streptococcus were recovered from wound or conjunctival cultures in 74% of 39 cases in Group I and 24% of cases in Group II (p<0.001). Thus, the bacterial etiology of orbital cellulitis varies with clinical presentation. Patients with cellulitis and an adjacent soft tissue focus of infection or trauma are likely to have gram-positive pathogens. Patients lacking such a focus are similar to children with facial cellulitis in that bacteremia is encountered frequently and H. influenzae is the common etiological agent.
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Gellady, A., Shulman, S. & Ayoub, E. ORBITAL CELLULITIS IN CHILDREN. Pediatr Res 11, 500 (1977). https://doi.org/10.1203/00006450-197704000-00779
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DOI: https://doi.org/10.1203/00006450-197704000-00779