Microbiology and outcome of pediatric orbital cellulitis in a Tertiary Eye Care Center in Saudi Arabia after the routine administration of Type B vaccine.

PURPOSE

To evaluate the incidence of pediatric related orbital cellulitis after the routine administration of the vaccine in Saudi Arabia and to identify the most common pathogens, predisposing factors, related complications, and the need for surgical intervention.

METHODS

A retrospective chart review was performed of patients with a discharge diagnosis of orbital cellulitis who presented to the King Abdul Aziz University Hospital, Riyadh, Saudi Arabia. Saudi children born between 2000 and 2016 were included.

RESULTS

Thirty-one cases were included and 8 had positive cultures. No cases of were found. Of all the positive culture, the most common pathogens isolated were , and group A Streptococcus in 3 cases (37.5%), 2 cases (25%) and 2 cases (25%). The most common predisposing factor was sinusitis in 90.3% of cases. Sixteen patients (51.6%) developed complications. Fifteen patients (48.3%) developed subperiosteal abscesses, 1 patient (3.22%) developed a lid abscess, 2 patients (6.45%) developed recurrent orbital cellulitis, and 1 patient (3.22%) developed persistent strabismus. Only 10 (31.25%) patients underwent surgical intervention during admission.

CONCLUSION

The vaccine seems to be effective at eliminating the orbital cellulitis potentially related to . The most common current pathogens were Gram-positive Staphylococcus and Streptococcus species. Sinusitis remains the most common cause of orbital cellulitis in children. In select cases, medical treatment can resolve the infections however, close observation is warranted.