Intracranial infection associated with preseptal and orbital cellulitis in the pediatric patient

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Dorothy J ReynoldsI Rand Rodgers

Abstract

To identify risk factors in children admitted with preseptal or orbital cellulitis with associated intracranial infection. A retrospective chart review identified 10 patients (< or = 18 years) with a diagnosis of preseptal or orbital cellulitis and a concurrent or subsequent diagnosis of intracranial infection. Diagnoses confirmed by imaging included sinusitis (n = 10), preseptal cellulitis (n = 4), orbital cellulitis (n = 6), orbital subperiosteal abscess (n = 5), Pott's puffy tumor (n = 4), epidural empyema (n = 2), epidural abscess (n = 6), and brain abscess (n = 2). The timing of diagnosis of intracranial infection ranged from hospital day 1 to 21. All but 1 patient had positive microbial cultures. Seven of 10 patients had positive microbial cultures from two or more sites, 70% of which were polymicrobial; Streptococcus species and Staphylococcus species were the most commonly isolated bacterial pathogens. All patients required both medical and surgical therapy; all 10 patients underwent sinus surgery; 8 patients required neurosurgical craniotomy; and 5 patients underwent orbital surgery. There were no deaths. Intracranial involvement should be suspected in any patient age > or = 7 years with preseptal or orbital cellulitis...Continue Reading

Citations

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Related Concepts

Antibiotics
Phlegmon
Orbit (Eye Disorders)
Periosteum
Retrospective Studies
Sinusitis
Tomography, X-Ray Computerized Axial
Streak Plate Count
Neurosurgical Procedures
Central Nervous System Bacterial Infections

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