Orbital cellulitis in children.
BACKGROUND
To review the epidemiology and management of orbital cellulitis in children.


METHODS
The medical records of children < or = 18 years old and hospitalized from June 1, 1992, through May 31, 2002, at the Brenner Children's Hospital, with a discharge ICD-9 code indicating a diagnosis of orbital cellulitis and confirmed by computed tomography scan were reviewed. A literature search for additional studies for systematic review was also conducted.


RESULTS
Forty-one children with orbital cellulitis were identified. The mean age was 7.5 years (range, 10 months to 16 years), and 30 (73%) were male (male:female ratio = 2.7). All cases of orbital cellulitis were associated with sinusitis; ethmoid sinusitis was present in 40 (98%) patients. Proptosis and/or ophthalmoplegia was documented in 30 (73%), and 34 (83%) had subperiosteal and/or orbital abscesses. Twenty-nine (71%) had surgical drainage and 12 (29%) received antibiotic therapy only. The mean duration of hospitalization was 5.8 days. The mean duration of antibiotic therapy was 21 days.


CONCLUSIONS
Orbital cellulitis occurs throughout childhood and in similar frequency among younger and older children. It is twice as common among males as females. Selected cases of orbital cellulitis, including many with subperiosteal abscess, can be treated successfully without surgical drainage.
Nageswaran
Savithri
S
Department of Pediatrics, Wake Forest University Health Sciences and Brenner Children's Hospital, Winston-Salem, NC 27157, USA.
Woods
Charles R
CR
Benjamin
Daniel K
DK
Givner
Laurence B
LB
Shetty
Avinash K
AK
D000038:Abscess / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000453:epidemiology* / Q000628:therapy*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D009916:Orbital Diseases / Q000453:epidemiology* / Q000628:therapy*; D012852:Sinusitis / Q000150:complications; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents