Department of Ophthalmology, Ninewells Hospital, Dundee, UK.
Glasgow Centre for Ophthalmic Research, Greater Glasgow & Clyde, Glasgow, UK.
Br J Ophthalmol. 2014 Nov;98(11):1575-8. doi: 10.1136/bjophthalmol-2014-305222. Epub 2014 Jun 17.
Orbital cellulitis is a potentially blinding and life-threatening condition. There are little published data on the incidence of orbital cellulitis and little is known about the differences between children and adults affected. The purpose of this study was to identify the incidence, aetiology, management and outcome of orbital cellulitis in children and adults in Scotland.
This study was a 1-year prospective observational study using the Scottish Ophthalmic Surveillance Unit reporting system among Scottish ophthalmologists.
The response rate from ophthalmologists was 66.4%. There were 15 children and 5 adults reported giving an incidence of 1.6 per 100 000 and 0.1 per 100 000 in children and adults, respectively. 47% of children had a preceding upper respiratory tract infection with 87% having radiological evidence of sinus disease. Within the adult group, there was preceding immunosuppression and trauma. Streptococcus (66%) and Haemophilus (46%) species were the most commonly isolated pathogens in children. Respiratory pathogens were less predictable in adults. All patients were treated with intravenous antibiotics. All children with orbital and subperiosteal abscesses had surgery; one adult with orbital abscess did not have surgery. There were two cases of series morbidity: one intracranial spread of infection and one evisceration.
The incidence of orbital cellulitis is higher in children than in adults. In children, it commonly follows upper respiratory infection and sinus disease; however, in adults, preceding illness and trauma are more common. Respiratory pathogens are common in affected children. Intravenous antibiotics and surgical treatment of abscesses remain the preferred management.
眶蜂窝织炎是一种潜在的致盲和危及生命的疾病。目前发表的关于眶蜂窝织炎发病率的数据很少，人们对儿童和成人患者之间的差异也知之甚少。本研究的目的是确定苏格兰儿童和成人眶蜂窝织炎的发病率、病因、治疗方法和结局。
这是一项为期 1 年的前瞻性观察研究，利用苏格兰眼科监测单位的报告系统，对苏格兰眼科医生进行调查。
眼科医生的回复率为 66.4%。报告了 15 名儿童和 5 名成人患者，儿童的发病率为每 10 万人 1.6 例，成人的发病率为每 10 万人 0.1 例。47%的儿童有上呼吸道感染病史，87%的儿童有鼻窦疾病的放射学证据。在成人组中，有免疫抑制和外伤的病史。儿童中最常见的分离病原体为链球菌（66%）和流感嗜血杆菌（46%）。在成人中，呼吸道病原体则更难预测。所有患者均接受静脉抗生素治疗。所有眶周和骨膜下脓肿的儿童均接受手术治疗；1 名眶脓肿的成人未接受手术治疗。有 2 例出现系列并发症：1 例感染颅内扩散，1 例眼球脱出。
儿童眶蜂窝织炎的发病率高于成人。在儿童中，它通常继发于上呼吸道感染和鼻窦疾病；然而，在成人中，先前的疾病和外伤更为常见。呼吸道病原体在受影响的儿童中很常见。静脉抗生素和脓肿的手术治疗仍然是首选的治疗方法。
