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Medical Therapy for Bacterial Preseptal and Orbital Cellulitis Associated with Sinusitis

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Orbital Cellulitis and Periorbital Infections

Abstract

Nonsurgical medical therapies are currently the mainstay for managing most cases of orbital cellulitis, with or without abscess. With improved understanding of the underlying etiologies and microbiology that cause orbital cellulitis, prompt and aggressive local and systemic treatments, antibiotics, and corticosteroids allow many patients to be successfully treated without undergoing the risks or sequelae of surgical intervention. While certain patients still require surgical intervention, medical therapies remain the first-line treatment in most cases of bacterial and fungal orbital cellulitis.

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References

  1. Gamble RC. Acute inflammation of the orbit in children. Arch Ophthalmol. 1933;10:483–97.

    Article  Google Scholar 

  2. Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80(9):1414–28.

    Article  CAS  Google Scholar 

  3. Welsh LW, Welsh JJ. Orbital complications of sinus diseases. Laryngoscope. 1974;84(5):848–56.

    Article  CAS  PubMed  Google Scholar 

  4. Schramm VL, Myers EN, Kennerdell JS. Orbital complications of acute sinusitis: evaluation, management, and outcome. Otolaryngology. 1978;86(2):ORL221–30.

    Article  CAS  PubMed  Google Scholar 

  5. Shapiro ED, Wald ER, Brozanski BA. Periorbital cellulitis and paranasal sinusitis: a reappraisal. Pediatr Infect Dis. 1982;1(2):91–4.

    Article  CAS  PubMed  Google Scholar 

  6. Mills RP, Kartush JM. Orbital wall thickness and the spread of infection from the paranasal sinuses. Clin Otolaryngol Allied Sci. 1985;10(4):209–16.

    Article  CAS  PubMed  Google Scholar 

  7. Kronschnabel EF. Orbital apex syndrome due to sinus infection. Laryngoscope. 1974;84(3):353–71.

    Article  CAS  PubMed  Google Scholar 

  8. Rubinstein JB, Handler SD. Orbital and periorbital cellulitis in children. Head Neck Surg. 1982;5(1):15–21.

    Article  CAS  PubMed  Google Scholar 

  9. Weiss A, Friendly D, Eglin K, Chang M, Gold B. Bacterial periorbital and orbital cellulitis in childhood. Ophthalmology. 1983;90(3):195–203.

    Article  CAS  PubMed  Google Scholar 

  10. Jones DB, Steinkuller PG. Strategies for the initial management of acute preseptal and orbital cellulitis. Trans Am Ophthalmol Soc. 1988;86:94–108.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Williams SR, Carruth JA. Orbital infection secondary to sinusitis in children: diagnosis and management. Clin Otolaryngol Allied Sci. 1992;17(6):550–7.

    Article  CAS  PubMed  Google Scholar 

  12. Kinis V, Ozbay M, Bakir S, et al. Management of orbital complications of sinusitis in pediatric patients. J Craniofac Surg. 2013;24(5):1706–10.

    Article  PubMed  Google Scholar 

  13. Al-madani MV, Khatatbeh AE, Rawashdeh RZ, Al-khtoum NF, Shawagfeh NR. The prevalence of orbital complications among children and adults with acute rhinosinusitis. Braz J Otorhinolaryngol. 2013;79(6):716–9.

    Article  PubMed  Google Scholar 

  14. 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(8):1450–3.

    Article  CAS  PubMed  Google Scholar 

  15. Mckinley SH, Yen MT, Miller AM, Yen KG. Microbiology of pediatric orbital cellulitis. Am J Ophthalmol. 2007;144(4):497–501.

    Article  PubMed  Google Scholar 

  16. Gonzalez MO, Durairaj VD. Understanding pediatric bacterial preseptal and orbital cellulitis. Middle East Afr J Ophthalmol. 2010;17(2):134–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Barone SR, Aiuto LT. Periorbital and orbital cellulitis in the haemophilus influenzae vaccine era. J Pediatr Ophthalmol Strabismus. 1997;34(5):293–6.

    CAS  PubMed  Google Scholar 

  18. 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;139(3):223–7.

    Article  PubMed  Google Scholar 

  19. Nageswaran S, Woods CR, Benjamin DK, Givner LB, Shetty AK. Orbital cellulitis in children. Pediatr Infect Dis J. 2006;25(8):695–9.

    Article  PubMed  Google Scholar 

  20. Brook I. Role of methicillin-resistant Staphylococcus aureus in head and neck infections. J Laryngol Otol. 2009;123(12):1301–7.

    Article  CAS  PubMed  Google Scholar 

  21. Garcia GH, Harris GJ. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988-1998. Ophthalmology. 2000;107(8):1454–6.

    Article  CAS  PubMed  Google Scholar 

  22. 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 Staphylococcus aureus in a tertiary hospital in India. Indian J Ophthalmol. 2011;59(6):431–5.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Seltz LB, Smith J, Durairaj VD, Enzenauer R, Todd J. Microbiology and antibiotic management of orbital cellulitis. Pediatrics. 2011;127(3):e566–72.

    Article  PubMed  Google Scholar 

  24. Chaudhry IA, Shamsi FA, Elzaridi E, et al. Outcome of treated orbital cellulitis in a tertiary eye care center in the middle east. Ophthalmology. 2007;114(2):345–54.

    Article  PubMed  Google Scholar 

  25. Brook I. Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management. Int J Pediatr Otorhinolaryngol. 2009;73(9):1183–6.

    Article  PubMed  Google Scholar 

  26. Yang M, Quah BL, Seah LL, Looi A. Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 2009;28(2–3):124–36.

    Article  PubMed  Google Scholar 

  27. Onakpoya OH, Adeoye AO, Akinpelu OV. Cost-related antibiotic dosage omissions-challenge for orbital cellulitis management in resource poor communities. Orbit. 2009;28(2–3):147–52.

    Article  PubMed  Google Scholar 

  28. Demuri GP, Wald ER. Complications of acute bacterial sinusitis in children. Pediatr Infect Dis J. 2011;30(8):701–2.

    Article  PubMed  Google Scholar 

  29. Bedwell J, Bauman NM. Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg. 2011;19(6):467–73.

    Article  PubMed  Google Scholar 

  30. Atfeh MS, Khalil HS. Orbital infections: five-year case series, literature review and guideline development. J Laryngol Otol. 2015;129(7):670–6.

    Article  CAS  PubMed  Google Scholar 

  31. 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;72(3):377–83.

    Article  CAS  PubMed  Google Scholar 

  32. Marchiano E, Raikundalia MD, Carniol ET, et al. Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data. Laryngoscope. 2016;126(3):554–9.

    Article  PubMed  Google Scholar 

  33. Yen MT, Yen KG. Effect of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess. Ophthal Plast Reconstr Surg. 2005;21(5):363–6.

    Article  PubMed  Google Scholar 

  34. Pushker N, Tejwani LK, Bajaj MS, Khurana S, Velpandian T, Chandra M. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156(1):178–183.e1.

    Google Scholar 

  35. 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(5):364–8.

    Article  PubMed  Google Scholar 

  36. Peden MC, Neelakantan A, Orlando C, Khan SA, Lessner A, Bhatti MT. Breaking the mold of orbital cellulitis. Surv Ophthalmol. 2008;53(6):631–5.

    Article  PubMed  Google Scholar 

  37. Mccarty ML, Wilson MW, Fleming JC, et al. Manifestations of fungal cellulitis of the orbit in children with neutropenia and fever. Ophthal Plast Reconstr Surg. 2004;20(3):217–23.

    Article  PubMed  Google Scholar 

  38. Gregory JE, Golden A, Haymaker W. Mucormycosis of the cerebral nervous system: a report of three cases. Bull Johns Hopkins Hosp. 1943;73:405.

    Google Scholar 

  39. Hale LM. Orbital-cerebral phycomycosis. Report of a case and a review of the disease in infants. Arch Ophthalmol. 1971;86(1):39–43.

    Article  CAS  PubMed  Google Scholar 

  40. Kronish JW, Johnson TE, Gilberg SM, Corrent GF, Mcleish WM, Scott KR. Orbital infections in patients with human immunodeficiency virus infection. Ophthalmology. 1996;103(9):1483–92.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Michael T. Yen MD .

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Weber, A.C., Yen, M.T. (2018). Medical Therapy for Bacterial Preseptal and Orbital Cellulitis Associated with Sinusitis. In: Yen, M., Johnson, T. (eds) Orbital Cellulitis and Periorbital Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-62606-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-62606-2_6

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-62606-2

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