Clinical analysis of 86 juvenile cases of periorbital cellulitis / 中华全科医师杂志

ABSTRACT

The clinical data of 86 juvenile cases of periorbital cellulitis treated in the Lianyungang Hospital from March 2010 to December 2020 were retrospectively analyzed, including 72 cases of pre-orbital septal infection (44 males, aged 0.5-11.0 years) and 14 cases of post-orbital septal infection (9 males, aged 2.0-17.0 years). The age of pre-orbital septal infection [(6.14±2.18)years] was higher than that of pre-orbital [(3.71±2.83) years, P<0.05]. Sinusitis was the main cause of periorbital cellulitis in juvenile, accounting for 62.8%. All patients showed local symptoms such as eyelid redness, swelling and tenderness; 9 patients with post-orbital cellulitis were accompanied by limited eye movement and exophthalmos. CT scan was performed in all 86 patients and showed that the normal interface of anterior orbital septal space was disappeared and the density of orbital soft tissue was increased; the ocular compression and displacement were observed in 12 patients with post-orbital septal cellulitis. MRI was performed in 7 patients with post-orbital infection and showed that the orbital fat space was blurred, and the long T1 and T2 signals of orbital circumference were observed. Laboratory tests showed the increase of leukocyte count (WBC) and C-reactive protein (CRP); compared to pre-orbital septal infection there was a tendency of higher WBC and CRP in post-orbital infection patients, but the difference was not significant ( P>0.05). Blood culture was carried out in 69 patients. 5 pathogenic bacteria in post-orbital septal infection patients were isolated, including S. aureus in 4 cases and H. influenzae in 1 case. All patients were treated with local antibiotic eye drops combined with intravenous antibiotics; incision drainage was performed in 1 case and ultrasound-guided needle puncture drainage in 3 cases. All the patients were cured. It is suggested that there are differences in age and clinical manifestations between patients with pre-orbital septal infection and post-orbital septal infection. CT and MRI are important for the differential diagnosis of them. Local eye drops of antibiotics combined with intravenous infusion are mainly used for treatment.