title: Management of paediatric periorbital cellulitis: Our experience of 243 children managed according to a standardised protocol 2012-2015.
abstract: BACKGROUND
  Paediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol.
  
  
  METHODS
  Retrospective audit of paediatric patients admitted with periorbital cellulitis, 2012-2015.
  
  
  RESULTS
  Total of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%.
  
  
  CONCLUSIONS
  Our audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms.
authors.affiliation: Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland. Electronic address: crosbie.robin@gmail.com.
authors.forename: Robin A
authors.initials: RA
authors.lastname: Crosbie
authors.affiliation: University of Dundee Medical School, Dundee, Scotland.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Nairn
authors.affiliation: Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland.
authors.forename: Haytham
authors.initials: H
authors.lastname: Kubba
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging; D002481:Cellulitis / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004322:Drainage; D005260:Female; D006192:Haemophilus Infections / Q000000981:diagnostic imaging / Q000628:therapy*; D006193:Haemophilus influenzae; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D010372:Pediatrics; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000628:therapy*; D034366:Streptococcus anginosus; D013296:Streptococcus pneumoniae; D013297:Streptococcus pyogenes; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cellulitis; Periorbital; Protocol