Effect of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess.
OBJECTIVE
To determine the effect of intravenous corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess.


METHODS
The inpatient records of all patients treated for orbital cellulitis with subperiosteal orbital abscess between January 2001 and August 2003 were reviewed. The use of corticosteroids, length of hospital stay, need for surgical drainage, treatment course, and clinical outcomes were reviewed. A t test and Fisher exact test analysis were calculated to evaluate statistical significance.


RESULTS
Twelve patients received intravenous corticosteroids and 11 patients did not receive corticosteroids. All patients had complete resolution of their abscess without complications. Length of hospitalization between the patients treated with and without intravenous corticosteroids was not significantly different (p = 0.26). Four of 12 patients treated with intravenous corticosteroids underwent orbitotomy for drainage of the abscess, and 6 of 11 patients treated without intravenous corticosteroids underwent surgical drainage (p = 0.20). Two of 12 patients treated with corticosteroids received intravenous antibiotics after discharge, whereas 7 of 11 in the group not treated with corticosteroids received intravenous antibiotics after discharge (p = 0.03).


CONCLUSIONS
The use of intravenous corticosteroids does not appear to adversely affect clinical outcomes and may be beneficial in the treatment of pediatric orbital cellulitis with subperiosteal abscess. Review of our data suggests that a prospective, randomized trial is warranted to further clarify the role of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess.
Yen
Michael T
MT
Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA. myen@bcm.tmc.edu
Yen
Kimberly G
KG
D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D000293:Adolescent; D002481:Cellulitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D010522:Periostitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids