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Interdisciplinary care in orbital complications of acute rhinosinusitis in children.
Trbojevic, Tena; Penezic, Ana; Sitas, Ingrid; Grgic, Marko Velimir; Ravlic, Maja Malenica; Stefanovic, Iva Mihatov.
Afiliación
  • Trbojevic T; Department of Pediatrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
  • Penezic A; Department of Otorhinolaryngology and Head and Neck Surgery, Sestre Milosrdnice University Hospital, Zagreb, Croatia, University of Zagreb, School of Medicine, Zagreb, Croatia.
  • Sitas I; Department of Pediatrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
  • Grgic MV; Department of Otorhinolaryngology and Head and Neck Surgery, Sestre Milosrdnice University Hospital, Zagreb, Croatia, University of Zagreb, School of Medicine, Zagreb, Croatia.
  • Ravlic MM; Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
  • Stefanovic IM; Department of Pediatrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia, University of Zagreb, School of Medicine, Zagreb, Croatia, University of Zagreb, School of Dental Medicine, Zagreb, Croatia.
Indian J Ophthalmol ; 71(1): 242-248, 2023 01.
Article en En | MEDLINE | ID: mdl-36588244
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Orbitales / Sinusitis / Exoftalmia / Oftalmopatías / Celulitis Orbitaria Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Indian J Ophthalmol Año: 2023 Tipo del documento: Article País de afiliación: Croacia Pais de publicación: India

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Orbitales / Sinusitis / Exoftalmia / Oftalmopatías / Celulitis Orbitaria Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Indian J Ophthalmol Año: 2023 Tipo del documento: Article País de afiliación: Croacia Pais de publicación: India