Periorbital cellulitis in the pediatric population: clinical features and management of 117 cases.

OBJECTIVE Since the advent of the Haemophilus influenzae type B vaccine, no North American case series has described periorbital cellulitis extensively as the main focus in the otolaryngology literature has been the management of orbital abscesses. The aim of this study was to describe the epidemiology, underlying causes, clinical presentation, and medical management of periorbital cellulitis. STUDY DESIGN Retrospective observational case series. SETTING Montreal Children's Hospital, McGill University Health Centre, a tertiary pediatric referral center in Montreal, Quebec. SUBJECTS AND METHODS The medical charts of all pediatric patients hospitalized from January 2000 to August 2006 with a discharge ICD-9 code indicating a diagnosis of periorbital cellulitis without abscess were reviewed. One hundred seventeen cases were identified. RESULTS Periorbital cellulitis in the pediatric population affects mainly preschool-aged patients (mean age 4.1 ± 4.2 years [SD]) and is more frequent among males than females (1.3:1). The most common predisposing conditions are sinusitis (24.8%), trauma (23.1%), and ocular conditions (13.7%). All patients were successfully managed with intravenous antibiotics for a mean period of 3.4 ± 2.6 days and oral antibiotics for 8.1 ± 4.4 days and recovered fully without complications. CONCLUSION Our results are consistent with the literature on the subject and show that timely identification of periorbital cellulitis cases and appropriate medical management result in resolution of the condition without complications.