Mishra Santosh Kumar, Kumar Sunil, Kumari Arti, Sharma Nageshwar
Department of Ophthalmology, Patna Medical College, Patna, Bihar, India.
Department of Obstetrics and Gynecology, Nalanda Medical College, Patna, Bihar, India.
J Family Med Prim Care. 2024 Oct;13(10):4712-4714. doi: 10.4103/jfmpc.jfmpc_847_24. Epub 2024 Oct 18.
Orbital cellulitis is an acute post-septal orbital infection caused mostly by bacteria. This may result in serious complications including blindness, meningitis, cavernous sinus thrombosis, brain abscess, and even death. The delay in treatment increases morbidity and mortality. The purpose of present study was to review cases of orbital cellulitis in recent years regarding its clinical presentation, diagnostic evaluation, treatment policy, complications, and disabilities. The outcome of study will help in early diagnosis and better management of orbital cellulitis cases.
Total 20 cases of orbital cellulitis in children from March 2021 to February 2024 were evaluated and analyzed in department of ophthalmology, Patna Medical College and Hospital, Patna.
Total 20 children with ages <18 years were evaluated. The average age of presentation was 7 years (range between 1 year and 17 years). 70% of cases were seen in male children. All patients presented with chemosis, congestion, eyelid swelling, proptosis, and restriction of eye movement. Orbital CT scan diagnosed 100% cases of orbital cellulitis ( < 0.01). In 45% of children, sinusitis was initial site of infection ( < 0.01). Swab culture was positive in 40% of the cases, organism being gram-positive cocci. Complete recovery was seen in 75% with 25% having some deficit in visual acuity or eye movement.
Clinical symptoms and signs aided with orbital CT scan help in early diagnosis early detection and aggressive treatment with multidisciplinary approach may limit the complications of orbital cellulitis and also aid in complete recovery without any visual deficit.
眼眶蜂窝织炎是一种主要由细菌引起的急性眶隔后感染。这可能导致包括失明、脑膜炎、海绵窦血栓形成、脑脓肿甚至死亡在内的严重并发症。治疗延迟会增加发病率和死亡率。本研究的目的是回顾近年来眼眶蜂窝织炎病例的临床表现、诊断评估、治疗策略、并发症和残疾情况。研究结果将有助于眼眶蜂窝织炎病例的早期诊断和更好的管理。
对2021年3月至2024年2月在巴特那医学院和医院眼科评估和分析的20例儿童眼眶蜂窝织炎病例进行了研究。
共评估了20名年龄<18岁的儿童。就诊时的平均年龄为7岁(范围在1岁至17岁之间)。70%的病例见于男童。所有患者均出现结膜水肿、充血、眼睑肿胀、眼球突出和眼球运动受限。眼眶CT扫描确诊眼眶蜂窝织炎的病例为100%(P<0.01)。45%的儿童最初感染部位为鼻窦炎(P<0.01)。40%的病例拭子培养呈阳性,病原体为革兰氏阳性球菌。75%的患者完全康复,25%的患者视力或眼球运动有一定缺陷。
临床症状和体征辅以眼眶CT扫描有助于早期诊断,早期发现并采用多学科方法积极治疗可能会限制眼眶蜂窝织炎的并发症,也有助于完全康复且无任何视力缺陷。