Georgakopoulos Constantine D, Eliopoulou Maria I, Stasinos Stavros, Exarchou Artemis, Pharmakakis Nikolaos, Varvarigou Anastasia
Department of Ophthalmology, Medical School, University of Patras, Patras, Greece.
Eur J Ophthalmol. 2010 Nov-Dec;20(6):1066-72. doi: 10.1177/112067211002000607.
Periorbital cellulitis is often difficult to distinguish from orbital cellulitis, which is a potentially lethal infection involving the contents of the orbit. A delay in diagnosis and appropriate treatment may result in serious complications. We studied the predisposing factors, microbiologic data, clinical features, complications, and treatment of periorbital and orbital cellulitis in childhood.
Eighty-three medical records of patients (mean age 3.7 ± 3.1 years) admitted to the Department of Pediatrics with a diagnosis of periorbital or orbital cellulitis during the 10-year period January 1997 to December 2007 were retrospectively studied.
In this series, periorbital cellulitis occurred more frequently (83%) than orbital cellulitis (17%). Of the children with periorbital cellulitis, 85% were younger than 5 years of age, while 62% of the children with orbital cellulitis were older than 5 years of age. The most common predisposing factors in periorbital cellulitis were upper respiratory infection (68%) and trauma to the eyelids (20%), while sinusitis was more frequently associated with orbital cellulitis (79%). Blood and skin cultures were usually negative. The most common isolated pathogens were Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus epidermidis. Forty-five of the 83 children were treated with intravenous ceftriaxone + clindamycin (mean duration 8.6 ± 5.5 days). Intravenous antibiotics alone was an effective management in most of the patients, but a small proportion (6%) required surgical intervention.
Upper respiratory infection and sinusitis are the most important predisposing factors for periocular infection. Streptococcus species are the predominant causative agents. Both diseases can usually be successfully treated with intravenous antibiotics, but some patients may require surgery to control extensive infection.
眶周蜂窝织炎常难以与眼眶蜂窝织炎相区分，眼眶蜂窝织炎是一种累及眶内容物的潜在致命性感染。诊断和适当治疗的延迟可能导致严重并发症。我们研究了儿童眶周和眼眶蜂窝织炎的易感因素、微生物学数据、临床特征、并发症及治疗。
回顾性研究了1997年1月至2007年12月这10年间儿科收治的83例诊断为眶周或眼眶蜂窝织炎患者（平均年龄3.7±3.1岁）的病历。
在本系列研究中，眶周蜂窝织炎的发生率（83%）高于眼眶蜂窝织炎（17%）。眶周蜂窝织炎患儿中，85%年龄小于5岁，而眼眶蜂窝织炎患儿中62%年龄大于5岁。眶周蜂窝织炎最常见的易感因素是上呼吸道感染（68%）和眼睑外伤（20%），而鼻窦炎与眼眶蜂窝织炎的相关性更高（79%）。血培养和皮肤培养通常为阴性。最常见的分离病原体是金黄色葡萄球菌、肺炎链球菌和表皮葡萄球菌。83例患儿中有45例接受了静脉注射头孢曲松+克林霉素治疗（平均疗程8.6±5.5天）。单独使用静脉抗生素对大多数患者是有效的治疗方法，但一小部分（6%）患者需要手术干预。
上呼吸道感染和鼻窦炎是眼周感染最重要的易感因素。链球菌是主要的致病原。这两种疾病通常用静脉抗生素治疗可成功治愈，但一些患者可能需要手术来控制广泛的感染。
