Abstract • A review of 104 patients with acute orbital cellulitis during the past decade showed that the frequency of hospital admissions for this disease has increased recently. Roentgenograms showed paranasal sinus in 77 of 91 patients. Haemophilus influenzae and Diplococcus pneumoniae were recovered from the blood of 20 and 6 patients, respectively. Four children had concomitant H influenzae meningitis. Bacteremia was demonstrated in 29% and more common in those with extensive orbital involvement, those not receiving antibiotics at the time of culture, and those less than 2 years old. Some of the 26 patients with less extensive involvement were bacteremic (17%), had leukocytosis, or roentgenographic evidence of sinusitis. Most children received large doses of ampicillin sodium and methicillin sodium intravenously until signs and symptoms had almost abated. With this regimen, there were no orbital, ocular, or other complications. References 1. Chandler JR, Langenbrunner DJ, Stevens ER: The pathogenesis of orbital complications in acute sinusitis . Laryngoscope 80:1414-1428, 1970.Crossref 2. Londer L, Nelson DL: Orbital cellulitis due to Haemophilus influenzae . Arch Ophthalmol 91:89-91, 1974.Crossref 3. Smith AT, Spencer JT: Orbital complications resulting from lesions of the sinuses . Ann Otol Rhinol Laryngol 57:5-27, 1948. 4. Gamble RC: Acute inflammations of the orbit in children . Arch Ophthalmol 16:483-497, 1936. 5. Havener WH: Orbital cellulitis . Ohio Med J 55:1389, 1959. 6. Haynes RE, Cramblett HG: Acute ethmoiditis: Its relationship to orbital cellulitis . Am J Dis Child 114:261-267, 1967.Crossref 7. Hogan MJ, Zimmerman LE: Ophthalmic Pathology. Philadelphia, WB Saunders Co, 1962, pp 724-727. 8. Jarrett WH, Gutman FA: Ocular complications of infection in the paranasal sinuses . Arch Ophthalmol 81:683-688, 1969.Crossref 9. Illiff CE, Ossofsky JJ: Tumors of the Eye and Adnexa in Infancy and Childhood . Springfield, Ill, Charles C Thomas Publisher, 1962, pp 128-130. 10. Michaels RH: Increase in influenzal meningitis . N Engl J Med 285:666-667, 1971.Crossref 11. Nelson JD, Koontz WC: Septic arthritis in infants and children: A review of 117 cases . Pediatrics 38:966-971, 1966. 12. Honig PJ, Pasquariello PS, Stool SE: H influenzae pneumonia in infants and children . J Pediatr 83:215-219, 1973.Crossref 13. Medina DA, Fine RN: Haemophilus influenzae type b orbital cellulitis . Calif Med 107:181-183, 1967. 14. Roberts RB, Ribble JC: Bacterial meningitis , in Conn HF (ed): Current Therapy . Philadelphia. WB Saunders Co, 1974, p 35. 15. Scott GI: Orbital cellulitis and cavernous sinus thrombosis . Trans Ophthalmol Sco UK 80:435-449, 1960. 16. Nelson JD: Should ampicillin be abandoned for treatment of Haemophilus influenzae disease, editorial . JAMA 229:322-324, 1974.Crossref 17. Tomeh MO, Starr SE, McGowan JE Jr, et al: Ampicillin-resistant Haemophilus influenzae type b infection . JAMA 229:295-297, 1974.Crossref
Archives of Ophthalmology – American Medical Association
Published: May 1, 1976
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