Skip to main content
SpringerLink
Log in

Pediatric Orbital and Periocular Infections

  • Chapter
  • First Online:
Pediatric Oculoplastic Surgery

  • 1584 Accesses

Abstract

Orbital and periorbital infections are the most common causes of acute orbital inflammation in children. Despite the widespread availability of neuroimaging and advances in antibiotic therapy, these conditions may still result in significant morbidity and mortality. The conditions of orbital cellulitis and preseptal cellulitis may present with similar patterns of eyelid edema and erythema but are two distinct anatomic disease processes with different etiologies. Both conditions have a peak incidence in childhood.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jackson K, Baker SR. Clinical implications of orbital cellulitis. Laryngoscope. 1986;96:568–74.

    Article  CAS  PubMed  Google Scholar 

  2. Jackson K, Baker SR. Periorbital cellulitis. Acad Neck Surg. 1987;9:227–34.

    Article  CAS  Google Scholar 

  3. Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases. A retrospective review of 262 cases. Int J Pediatr Otorhinolaryngol. 2008 Mar;72:377–83.

    Article  CAS  PubMed  Google Scholar 

  4. Gonçalves R, Menezes C, Machado R, Ribeiro I, Lemos JA. Periorbital cellulitis in children: analysis of outcome of intravenous antibiotic therapy. Orbit. 2016 Aug;35:175–80.

    Article  PubMed  Google Scholar 

  5. Mathew AV, Craig E, Al-Mahmoud R, Batty R, Raghavan A, Mordekar SR, Chan J, Connolly DJ. Paediatric post-septal and pre-septal cellulitis: 10 years’ experience at a tertiary-level children’s hospital. Br J Radiol. 2014;87:1033.

    Article  Google Scholar 

  6. Chandler JR, Lanjenbrunner PJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80:1414–28.

    Article  CAS  PubMed  Google Scholar 

  7. Weiss A, Friendly D, Eglin K, et al. Bacterial periorbital and orbital cellulitis in childhood. Ophthalmology. 1983;90:195–203.

    Article  CAS  PubMed  Google Scholar 

  8. Israele V, Nelson JD. Periorbital and orbital cellulitis. Pediatr Infect Dis J. 1987;6:404–110.

    Article  CAS  PubMed  Google Scholar 

  9. Newell FW, Leveille AS. Management and complications of bacterial periorbital and orbital cellulitis. Metab Pediatr Syst Ophthalmol. 1982;6:209–14.

    CAS  PubMed  Google Scholar 

  10. Scott PM, Bloome MH. Lid necrosis secondary to streptococcal periorbital cellulitis. Ann Ophthalmol. 1981;13:461–5.

    CAS  PubMed  Google Scholar 

  11. Robbins JB, Schneerson R, Arguman M, Handzel ZT. Haemophilus influenzae type B: disease and immunity in humans. Ann Intern Med. 1973;78:259–69.

    Article  Google Scholar 

  12. Gellady AM, Schulman SJ, Ayoub EM. Periorbital and orbital cellulitis in children. Pediatrics. 1978;61:272–7.

    CAS  PubMed  Google Scholar 

  13. Rubinstein JB, Handler SD. Orbital and periorbital cellulitis in children. Head Neck Surg. 1982;5:15–21.

    Article  CAS  PubMed  Google Scholar 

  14. Pandian DG, Babu RK, Chaitra A, Anjali A, Rao VA, Srinivasan R. Nine years' review on preseptal and orbital cellulitis and emergence of community-acquired methicillin-resistant Staphylococus aureus in a tertiary hospital in India. Indian J Ophthalmol. 2011;59:431–5.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Peña MT, Preciado D, Orestes M, Choi S. Orbital complications of acute sinusitis: changes in the post-pneumococcal vaccine era. JAMA Otolaryngol Head Neck Surg. 2013 Mar;139(3):223–7.

    Article  PubMed  Google Scholar 

  16. Rimon A, Hoffer V, Prais D, Harel L, Amir J. Periorbital cellulitis in the era of Haemophilus influenzae type B vaccine: predisposing factors and etiologic agents in hospitalized children. J Pediatr Ophthalmol Strabismus. 2008;45:300–4.

    Article  PubMed  Google Scholar 

  17. Ambati BK, Ambati J, Azar N, Stratton L, Schmidt EV. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination. Ophthalmology. 2000;107:1450–3.

    Article  CAS  PubMed  Google Scholar 

  18. Sharma A, Liu ES, Le TD, Adatia FA, Buncic JR, Blaser S, Richardson S. Pediatric orbital cellulitis in the Haemophilus influenzae vaccine era. J AAPOS. 2015;19(3):206–10.

    Article  PubMed  Google Scholar 

  19. Shayegani A, MacFarlane D, Kazim M, Grossman ME. Streptococcal gangrene of the eyelids and orbit. Am J Ophthalmol. 1995;120:784–92.

    Article  CAS  PubMed  Google Scholar 

  20. Moss RL, Musemeche CA, Kosloske AM. Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. J Pediatr Surg. 1996;31:1142–6.

    Article  CAS  PubMed  Google Scholar 

  21. Dewan MA, Meyer DR, Wladis EJ. Orbital cellulitis with subperiosteal abscess: demographics and management outcomes. Ophthal Plast Reconstr Surg. 2011;27:330–2.

    Article  PubMed  Google Scholar 

  22. Schramm VL, Curtin HD, Kennerdell JS. Evaluation of orbital cellulitis and results of treatment. Laryngoscope. 1982;92:732–8.

    Article  PubMed  Google Scholar 

  23. Gans H, Sekula J, Wlodyka J. Treatment of acute orbital complications. Arch Otolaryngol. 1974;100:329–32.

    Article  CAS  PubMed  Google Scholar 

  24. Williamson-Nobel FA. Diseases of the orbit and its contents secondary to pathological conditions of the nose and paranasal sinuses. Ann R Coll Surg. 1954;15:46–64.

    Google Scholar 

  25. Stammberger H. Functional endoscopic sinus surgery. Philadelphia: Decker; 1991. p. 68.

    Google Scholar 

  26. Hubert L. Orbital infections due to nasal sinusitis. NY State J Med. 1937;37:1559–64.

    Google Scholar 

  27. Smith AT, Spencer ST. Orbital complications resulting from lesions of the sinuses. Ann Otol Rhinol Laryngol. 1948;57:5–27.

    Article  CAS  PubMed  Google Scholar 

  28. Le TD, Liu ES, Adatia FA, Buncic JR, Blaser S. The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 2014;18(3):271–7.

    Article  PubMed  Google Scholar 

  29. Handler EC, Davey IC, Hill JC, Lauryssen L. The acute orbit: differentiation of orbital cellulitis from periosteal abscess by computerized tomography. Neuroradiology. 1991;33:15–8.

    Article  CAS  PubMed  Google Scholar 

  30. Le TD, Liu ES, Adatia FA, Buncic JR, Blaser S. The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 2014;18:271–7.

    Article  PubMed  Google Scholar 

  31. Emmett Hurley P, Harris GJ. Subperiosteal abscess of the orbit: duration of intravenous antibiotic therapy in nonsurgical cases. Ophthal Plast Reconstr Surg. 2012;28(1):22–6.

    Article  CAS  PubMed  Google Scholar 

  32. Erickson BP, Lee WW. Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis. Orbit. 2015;34:115–20.

    Article  PubMed  Google Scholar 

  33. Rubin SE, Rubin LG, Zito J, Goldstein MN, Eng C. Medical management of orbital subperiosteal abscess in children. J Pediatr Ophthalmol Strabismus 1989;26:21–26.

    Google Scholar 

  34. Frank GS, Smith JM, Davies BW, Mirsky DM, Hink EM, Durairaj VD. Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children. JAAPOS. 2015;19(4):358–62.

    Google Scholar 

  35. McKinley SH, Yen MT, Miller AM, Yen KG. Microbiology of pediatric orbital cellulitis. Am J Ophthalmol. 2007;144:497–501.

    Article  PubMed  Google Scholar 

  36. Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology. 1994;101:585–95.

    Article  CAS  PubMed  Google Scholar 

  37. Pushker N, Tejwani LK, Bajaj MS, Khurana S, Velpandian T, Chandra M. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156:178–83.

    Article  CAS  PubMed  Google Scholar 

  38. Davies BW, Smith JM, Hink EM, Durairaj VD. C-reactive protein as a marker for initiating steroid treatment in children with orbital cellulitis. Ophthal Plast Reconstr Surg. 2015;31:364–8.

    Article  PubMed  Google Scholar 

  39. Liao JC, Harris GJ. Subperiosteal abscess of the orbit: evolving pathogens and the therapeutic protocol. Ophthalmology. 2015;122:639–47.

    Article  PubMed  Google Scholar 

  40. Shields JA, Shields CL, Survarnamanii C, et al. Retinoblastoma manifesting as orbital cellulitis. Am J Ophthmol. 1991;112:442–9.

    Article  CAS  Google Scholar 

  41. Walters EC, Waller H, Hiles DA, Michaels RH. Acute orbital cellulitis. Arch Ophthalmol. 1976;94:785–8.

    Article  Google Scholar 

  42. Baum JL. Rhinorbital mucormycosis occurring in an otherwise apparently healthy individual. Am J Ophthalmol. 1967;63:335–9.

    Article  CAS  PubMed  Google Scholar 

  43. Harris GJ, Will BR. Orbital aspergillosis: conservative debridement and local amphotericin irrigation. Ophthalmic Plast Reconstr Surg. 1989;5:207–11.

    Article  CAS  Google Scholar 

  44. Green WR, Font RL, Zimmerman LE. Aspergillosis of the orbit: report of ten cases and review of the literature. Arch Ophthalmol. 1969;82:302–13.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oculoplastic Surgery Service, Wills Eye Hospital, Department of Ophthalmology, Jefferson Medical College and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Scott M. Goldstein

  2. Oculo-facial Plastic Surgeon, Tri-County Eye Physicians and Divisions, Vantage EyeCare, Philadelphia, PA, USA

    Scott M. Goldstein

  3. Havener Eye Center at The Ohio State University and Oculoplastic Service, Nationwide Children’s Hospital, Columbus, OH, USA

    Jill A. Foster (Associate Clinical Professor of Ophthalmology)

  4. Ophthalmic Surgeons and Consultants of Ohio, Columbus, OH, USA

    Jill A. Foster (Associate Clinical Professor of Ophthalmology)

  5. The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia, PA, USA

    James A. Katowitz MD, FACS

Authors
  1. Scott M. Goldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jill A. Foster
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James A. Katowitz MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott M. Goldstein .

Editor information

Editors and Affiliations

  1. Professor Emeritus of Ophthalmology and Director of Oculoplastic and Orbital Surgery, The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania, USA

    James A. Katowitz

  2. Associate Professor of Clinical Ophthalmology and Director of the Oculoplastic and Orbital Surgery Fellowship Program, The Children’s Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    William R. Katowitz

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Goldstein, S.M., Foster, J.A., Katowitz, J.A. (2018). Pediatric Orbital and Periocular Infections. In: Katowitz, J., Katowitz, W. (eds) Pediatric Oculoplastic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-60814-3_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60814-3_33

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60812-9

  • Online ISBN: 978-3-319-60814-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation