Pediatric Periorbital and Orbital Cellulitis

Purpose: Orbital cellulitis may cause serious complications such as blindness, carvenous sinus thrombosis, and death if it would be misdiagnosed as periorbital cellulits and not treated properly. There were a few studies for children about these diseases in Korea. The purpose of this study is to know their clinical features and prognosis. Methods: I collected the clinical informations of periorbital and orbital cellulitis patients who had admitted at the Department of Pediatrics, YongIn Severance Hospital, YongIn, Korea from January 2003 to December 2010, retrospectively. Their demographics, clinical characteristics, treatments and complication were investigated. Results: There were two orbital and fifteen periorbital celluitis for 8 years. Periorbital cases showed a tendency to be younger than orbital cases (4.25±1.08 vs 6, 6.7 years old). Both orbital cases were composed of boys, but periorbital cases with eight boys and 7 girls. Sinusitis was observed in both orbital cases and six (40%) of periorbital cases. Frequent predisposing diseases for periorbital cases were conjunctivitis (40%), sinusitis (40%), skin infection (26.7%), acute otitis media (26.7%). All cases showed erythematous swelling and heating on eyes. Chemosis and proptosis were noted only in orbital cases. Elevation of leukocyte count, erythrocyte sediment ratio, and C-reactive protein was present in both orbital cases. Any elevation of them was observed in twelve patients (80%) of periorbital cases. Computed tomography (CT) has been performed in nine cases and two orbital cellulitis were confirmed. All patients recovered without surgery and complication. Conclusion: There is no distinct difference of clinical features between periorbital and orbital cellulits but ocular physical and CT findings. They can be managed without complication. Further large and multi hospital study should be done to establish the treatment guideline for them.prohibitio