Diagnosis and Treatment of Preseptal Cellulitis in the Pediatric age Group

Purpose: To report clinical features, etiology, management practices and outcomes of preseptal cellulitis in the pediatric age group. Material and Method: Retrospective chart review study. Result: The charts of 30 pediatric patients with preseptal cellulitis at Dokuz Eylul University Hospital from 2003 to 2007 were reviewed. 16 patients were female and 14 were male with a mean age of 4.28 years at presentation (min: 9 months, max: 11 years). Unilateral preseptal cellulitis was observed in 29 patients, while bilateral preseptal cellulitis was seen in one. The most common antecedent factors were acute sinusitis (63.3%) and herpetic blepharoconjunctivitis (23.3%). Inflammation overspread from the forehead to the other periorbital area in the patient with bilateral preseptal cellulitis. Thirteen patients underwent computed tomography examination, and ethmoidal and maxillary sinusites were most frequently observed. Eighteen patients were treated only with intravenous antibiotics, which were combined with surgical drainage because of abscess in one patient. Eleven patients were receiving oral antibiotics. Patients treated with intravenous antibiotics were hospitalized. Dacryocystorhinostomy and bicanalicular silicone tube implantation surgery were performed in 2 patients after treatment. Complete resolution without complication was achieved. Discussion: Periorbital microbial infections were usually associated with sinusitis in the pediatric age group. Early diagnosis and management of preseptal cellulitis is of great importance due to its vision-or life-threatening complications (e.g. brain abscess, meningitis, cavernous sinus thrombosis, etc.) that can be seen in cases of late or inadequate treatment.