Who should manage acute periorbital cellulitis in children?

Int J Pediatr Otorhinolaryngol

University of Liverpool, Cancer Research Centre, United Kingdom.

Published: August 2012

Introduction: Periorbital cellulitis is inflammation of the eye anterior to the palpebral ligament. The sequeale may be life or vision threatening. There is no consensus on the optimal management strategies.

Methods: A two year retrospective case note analysis was performed on all hospital admissions to a tertiary children's hospital with the diagnosis.

Results: 226 notes were retrieved, 13 were excluded. The incidence of periorbital cellulitis was nearly 9 cases per month (8.875): the median length of stay was 2 days: all were treated with antibiotics. Only 7 children (3%) underwent surgical intervention.

Discussion: Due to potentially serious intracranial and orbital complications, authors have previously argued that all patients with periorbital cellulitis need daily otorhinolaryngology assessment. This current review showed a much larger incidence than in the published literature, with the majority being managed by the paediatricians and ophthalmologists. Escalation to otorhinolaryngology when first line treatment has failed is a more appropriate use of resources.

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http://dx.doi.org/10.1016/j.ijporl.2012.04.012DOI Listing

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