Interdisciplinary care in orbital complications of acute rhinosinusitis in children
Purpose: Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully pa...
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| Veröffentlicht in: | Indian journal of ophthalmology 2023-01, Vol.71 (1), p.242-248 |
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| creator | Trbojevic, Tena Penezic, Ana Sitas, Ingrid Grgic, Marko Ravlic, Maja Stefanovic, Iva |
| description | Purpose: Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis. Methods: A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020. Results: A total of 26 children-median age 2.7 years (range 0.5-12)-were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1-12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented. Conclusion: Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis. |
| doi_str_mv | 10.4103/ijo.IJO_798_22 |
| format | Article |
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Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis. Methods: A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020. Results: A total of 26 children-median age 2.7 years (range 0.5-12)-were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1-12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented. Conclusion: Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.</description><identifier>ISSN: 0301-4738</identifier><identifier>EISSN: 1998-3689</identifier><identifier>DOI: 10.4103/ijo.IJO_798_22</identifier><identifier>PMID: 36588244</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Acute Disease ; Anti-Bacterial Agents - therapeutic use ; Care and treatment ; Cellulitis ; Child ; Child, Preschool ; Children ; Complications and side effects ; Development and progression ; Diseases ; Exophthalmos ; Eye diseases ; Eye Diseases - complications ; Humans ; Infant ; Interdisciplinary aspects ; Ophthalmoplegia ; Orbital cellulitis ; Orbital Cellulitis - diagnosis ; Orbital Cellulitis - etiology ; Orbital Cellulitis - therapy ; Orbital Diseases - diagnosis ; Orbital Diseases - etiology ; Orbital Diseases - therapy ; Original ; Patients ; Pediatrics ; Retrospective Studies ; Rhinitis ; Rhinosinusitis ; Sinus ; Sinusitis ; Sinusitis - complications ; Sinusitis - diagnosis ; Sinusitis - therapy</subject><ispartof>Indian journal of ophthalmology, 2023-01, Vol.71 (1), p.242-248</ispartof><rights>COPYRIGHT 2023 Medknow Publications and Media Pvt. Ltd.</rights><rights>2023. This article is published under (http://creativecommons.org/licenses/by-nc-sa/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright: © 2022 Indian Journal of Ophthalmology 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539s-31117ce5b3f41387c8e9269f4369c056def7bab76a2c38515c0253286748c5d23</citedby><cites>FETCH-LOGICAL-c539s-31117ce5b3f41387c8e9269f4369c056def7bab76a2c38515c0253286748c5d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155524/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155524/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27458,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36588244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trbojevic, Tena</creatorcontrib><creatorcontrib>Penezic, Ana</creatorcontrib><creatorcontrib>Sitas, Ingrid</creatorcontrib><creatorcontrib>Grgic, Marko</creatorcontrib><creatorcontrib>Ravlic, Maja</creatorcontrib><creatorcontrib>Stefanovic, Iva</creatorcontrib><title>Interdisciplinary care in orbital complications of acute rhinosinusitis in children</title><title>Indian journal of ophthalmology</title><addtitle>Indian J Ophthalmol</addtitle><description>Purpose: Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis. Methods: A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020. Results: A total of 26 children-median age 2.7 years (range 0.5-12)-were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1-12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented. Conclusion: Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.</description><subject>Acute Disease</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Care and treatment</subject><subject>Cellulitis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Diseases</subject><subject>Exophthalmos</subject><subject>Eye diseases</subject><subject>Eye Diseases - complications</subject><subject>Humans</subject><subject>Infant</subject><subject>Interdisciplinary aspects</subject><subject>Ophthalmoplegia</subject><subject>Orbital cellulitis</subject><subject>Orbital Cellulitis - diagnosis</subject><subject>Orbital Cellulitis - etiology</subject><subject>Orbital Cellulitis - therapy</subject><subject>Orbital Diseases - diagnosis</subject><subject>Orbital Diseases - etiology</subject><subject>Orbital Diseases - therapy</subject><subject>Original</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Rhinitis</subject><subject>Rhinosinusitis</subject><subject>Sinus</subject><subject>Sinusitis</subject><subject>Sinusitis - complications</subject><subject>Sinusitis - diagnosis</subject><subject>Sinusitis - therapy</subject><issn>0301-4738</issn><issn>1998-3689</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kktvEzEUhS0EoqGwZYlGYsNmgt-PFVQVj6BKXQBry-PxJE49drBnGvHvcdQXRaXywpLvd8_1uToAvEZwSREk7_02LVffzrVQUmP8BCyQUrIlXKqnYAEJRC0VRB6BF6VsISQCKfkcHBHOpMSULsD3VZxc7n2xfhd8NPl3Y012jY9Nyp2fTGhsGmvJmsmnWJo0NMbOk2vyxsdUfJyLn3w5NNiND3128SV4NphQ3Kvr-xj8_Pzpx-nX9uz8y-r05Ky1jKjSEoSQsI51ZKCISGGlU5irgRKuLGS8d4PoTCe4wZZIhpiFmBEsuaDSsh6TY_DhSnc3d6PrrYtTNkHvsh-rD52M1_cr0W_0Ol1qBBFjDNOq8O5aIadfsyuTHusmXAgmujQXjQWHSGCleEXf_oNu05xj9acJokxWiKnHqKqFOUKYoDtqbYLTPg6pfs8eRusTQbCgnNGDVvsAtXbRVS8pusHX53v88gG-nt6N3j7WYHMqJbvhdnUI6kO6dE2XvktXbXjz98Jv8Zs4VeDjFbBPocaqXIR577Ku7EVM-__Iakyxvokh-QOug-Aw</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Trbojevic, Tena</creator><creator>Penezic, Ana</creator><creator>Sitas, Ingrid</creator><creator>Grgic, Marko</creator><creator>Ravlic, Maja</creator><creator>Stefanovic, Iva</creator><general>Wolters Kluwer India Pvt. 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Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis. Methods: A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020. Results: A total of 26 children-median age 2.7 years (range 0.5-12)-were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1-12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented. Conclusion: Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>36588244</pmid><doi>10.4103/ijo.IJO_798_22</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Anti-Bacterial Agents - therapeutic use Care and treatment Cellulitis Child Child, Preschool Children Complications and side effects Development and progression Diseases Exophthalmos Eye diseases Eye Diseases - complications Humans Infant Interdisciplinary aspects Ophthalmoplegia Orbital cellulitis Orbital Cellulitis - diagnosis Orbital Cellulitis - etiology Orbital Cellulitis - therapy Orbital Diseases - diagnosis Orbital Diseases - etiology Orbital Diseases - therapy Original Patients Pediatrics Retrospective Studies Rhinitis Rhinosinusitis Sinus Sinusitis Sinusitis - complications Sinusitis - diagnosis Sinusitis - therapy |
| title | Interdisciplinary care in orbital complications of acute rhinosinusitis in children |
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