Division of Pediatric Emergency Medicine, Department of Pediatrics, Dana-Dwek Children Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada.
Am J Ther. 2019 Jan/Feb;26(1):e1-e4. doi: 10.1097/MJT.0000000000000596.
Preseptal (periorbital) and orbital cellulitis are potentially catastrophic infections near the eye. Preseptal cellulitis is far more common, and although classically reported to be associated with dacrocystitis, sinusitis/upper respiratory infection, trauma/surgery, or infection from contiguous areas, it can also be associated with insect bites. The objective of this study was to determine the prevalence of insect bite-associated preseptal cellulitis and to compare clinical findings and outcomes of these patients with those having other causes for the condition.
Retrospective chart review of children with a final discharge diagnosis of periorbital cellulitis from January 2009 to December 2014 at a tertiary care children' hospital.
213 children were diagnosed with preseptal cellulitis during the 5-year study period, of whom 60 (28%) were associated with insect bites. Patients in the noninsect bite group more commonly had fever at presentation (P < 0.001), with increased white blood cell and C reactive protein values (both P < 0.001). No patient with insect bite-associated preseptal cellulitis presented with fever, and none underwent radiographic testing or computerized tomography; their mean age was also lower (P < 0.001) and length of stay was significantly shorter.
This study suggests that children with preseptal cellulitis associated with insect bites could be candidates for oral antibiotic therapy with outpatient follow-up by.
眼眶前（眶周）蜂窝织炎和眼眶蜂窝织炎是眼部附近潜在的灾难性感染。眼眶前蜂窝织炎更为常见，尽管经典报道与泪囊炎、鼻窦炎/上呼吸道感染、创伤/手术或邻近区域感染有关，但也可能与昆虫叮咬有关。本研究的目的是确定与昆虫叮咬相关的眼眶前蜂窝织炎的患病率，并比较这些患者与其他病因患者的临床发现和结局。
回顾性分析 2009 年 1 月至 2014 年 12 月在一家三级儿童医院以眶周蜂窝织炎为最终出院诊断的儿童的病历。
在 5 年的研究期间，213 名儿童被诊断为眼眶前蜂窝织炎，其中 60 名（28%）与昆虫叮咬有关。非昆虫叮咬组患者在就诊时更常出现发热（P < 0.001），白细胞和 C 反应蛋白值升高（均 P < 0.001）。没有一例与昆虫叮咬相关的眼眶前蜂窝织炎患者出现发热，也没有一例进行影像学检查或计算机断层扫描；他们的平均年龄也较低（P < 0.001），住院时间明显缩短。
本研究表明，与昆虫叮咬相关的眼眶前蜂窝织炎患儿可能适合口服抗生素治疗，并可通过门诊随访进行治疗。
