title: Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess.
abstract: OBJECTIVE
  Controversies remain regarding the management of orbital cellulitis (OC). The objective of this study was to examine the outcomes of patients admitted to our institution for orbital cellulitis during a 7-year period.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary referral pediatric hospital.
  
  
  METHODS
  Charts of 465 consecutive OC admissions were reviewed for presentation, imaging, medical and surgical treatment, and outcome.
  
  
  RESULTS
  Of these patients, 189 were treated in the emergency room and 276 were admitted. CT scan was performed on 240 patients. Subperiosteal abscess (SPA) was noted in 68 patients. Of these, 47 were treated medically and 21 had surgery. Surgical patients were older (8.3 vs 6.2 years, P = 0.039), had larger abscesses (>10 mm, P < 0.001), required a longer admission (10.2 vs 6.6 days, P < 0.001), and had higher temperatures on admission (38.0 degrees C vs 37.3 degrees C, P = 0.03).
  
  
  CONCLUSIONS
  The majority of small SPAs as diagnosed on CT scans in younger children can be successfully treated medically. Surgery, however, should be considered for a worsening clinical examination. Our findings confirm those of previous reports on this clinical entity.
authors.affiliation: Department of Otolaryngology, National Naval Medical Center, Bethesda, MD, USA.
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Ryan
authors.forename: Diego A
authors.initials: DA
authors.lastname: Preciado
authors.forename: Nancy
authors.initials: N
authors.lastname: Bauman
authors.forename: Maria
authors.initials: M
authors.lastname: Pena
authors.forename: Sumit
authors.initials: S
authors.lastname: Bose
authors.forename: George H
authors.initials: GH
authors.lastname: Zalzal
authors.forename: Sukgi
authors.initials: S
authors.lastname: Choi
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D054517:Orbital Cellulitis / Q000000981:diagnostic imaging / Q000628:therapy*; D010521:Periosteum; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents