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婴儿眶脓肿:临床表现、微生物特征和治疗结果。

Infantile orbital abscess: clinical presentation, microbiological profile, and management outcomes.

机构信息

Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Chennai, India.

Department of Pediatric Ophthalmology & Strabismus, Sankara Nethralaya, Medical Research Foundation, Chennai, India.

出版信息

Orbit. 2022 Aug;41(4):422-428. doi: 10.1080/01676830.2021.1920040. Epub 2021 May 11.

Abstract

PURPOSE

Orbital abscesses in children are not uncommon. Unless managed in a timely fashion, they can potentially lead to vision-threatening as well as life-threatening complications. The objective of this study is to report the clinical and microbiological profile and management outcomes in infants presenting with orbital abscesses.

MATERIALS AND METHODS

A retrospective review of electronic medical records of children younger than 1 year with a diagnosis of an orbital abscess was done. The data was collected from a time period of 12 years (2007-2019). The data collected included mode of presentation, radiological, microbiological and histopathological features, and the final outcome.

RESULTS

A total of nine patients met the inclusion criteria. The mean age at presentation was 19 weeks. Three patients had upper respiratory tract infection, one had a congenital nasolacrimal duct obstruction, two had sinusitis, and one patient had neonatal sepsis. All patients underwent imaging following which abscess drainage was performed. Methicillin-sensitive Staphylococcus aureus was the most common organism, which was isolated in five patients, Methicillin-resistant S. aureus was isolated in three, while one patient had Entomophthorales fungal infection. The median follow-up period was 10 months (range 5 days to 89 months). There was no recurrence in the cohort. At least one patient had visual impairment at the last follow up.

CONCLUSION

Orbital abscesses in infants are rare. Imaging and prompt drainage of the abscess supplemented by appropriate antimicrobial regimen leads to a successful outcome.

摘要

目的

儿童眶脓肿并不罕见。如果不及时治疗,它们可能会导致威胁视力甚至危及生命的并发症。本研究旨在报告婴儿眶脓肿患者的临床和微生物特征以及治疗结果。

材料和方法

对 12 年来(2007-2019 年)电子病历中诊断为眶脓肿的 1 岁以下儿童进行回顾性分析。收集的资料包括表现方式、影像学、微生物学和组织病理学特征以及最终结果。

结果

共有 9 名患者符合纳入标准。发病时的平均年龄为 19 周。3 例上呼吸道感染,1 例先天性鼻泪管阻塞,2 例鼻窦炎,1 例新生儿败血症。所有患者均进行了影像学检查,随后进行脓肿引流。耐甲氧西林金黄色葡萄球菌是最常见的病原体,5 例患者分离出该菌,3 例患者分离出耐甲氧西林金黄色葡萄球菌,1 例患者分离出真菌 Entomo-phthorales。中位随访时间为 10 个月(5 天至 89 个月)。该队列中无复发。在最后一次随访时,至少有 1 名患者存在视力障碍。

结论

婴儿眶脓肿罕见。影像学检查和及时引流脓肿并辅以适当的抗菌药物治疗方案可获得良好的治疗效果。

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