PMID- 30856372
OWN - NLM
STAT- MEDLINE
DCOM- 20190717
LR  - 20190717
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 121
DP  - 2019 Jun
TI  - Recurrent periorbital cellulitis associated with rhinosinusitis in children: 
      Characteristics, course of disease, and management paradigm.
PG  - 26-28
LID - S0165-5876(19)30102-8 [pii]
LID - 10.1016/j.ijporl.2019.02.037 [doi]
AB  - BACKGROUND: Recurrent periorbital cellulitis (RPOC) associated with 
      rhinosinusitis is rarely noted and scarcely discussed in the literature. The aim 
      of our study was to analyze the characteristics and disease course of a group of 
      pediatric patients with RPOC. METHODS: The medical records of all pediatric 
      patients with a diagnosis of RPOC treated in a tertiary children's hospital were 
      retrieved. Included were patients with a history of two or more episode of RPOC. 
      RESULTS: A total of 14 children were included. Mean follow up was 3 years 
      (SD +/- 2.5). Median age of first POC episode was 12 months (range 5 months-12 
      years). Overall, 75 events of RPOCs were documented. A median of 3 events per 
      patient was noted (range 2-16). Preseptal cellulitis was diagnosed in all but 
      five patients, in whom orbital cellulitis or subperiosteal abscess were 
      identified, one following failure of conservative treatment, and the remaining at 
      first presentation or recurrence. Rhinorrhea was present in only five patients 
      (35%). The majority of patients were treated with intra-venous antibiotics. 
      Imaging studies were performed in all patients revealing ethmoidal sinusitis in 
      all patients, with lamina papyracea dehiscence in two patients. Immune deficiency 
      was diagnosed in one patient. Endoscopic sinus surgery was performed in seven 
      patients, in four as preventive procedure and in three during an acute phase. 
      Post-operative recurrent disease was noted in two patients that were operated 
      during the acute phase. CONCLUSIONS: RPOC is a rare entity. Rhinosinusitis should 
      be suspected in events of recurrent preseptal cellulitis even in the absence of 
      nasal symptoms. CT scan is diagnostic for sinus origin of disease and possible 
      anatomical abnormalities. In the majority of patients no evident etiology was 
      identified. Elective Surgery or prophylactic antibiotic treatment should be 
      strongly considered in this subgroup of patients as it seems beneficial.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Tzelnick, Sharon
AU  - Tzelnick S
AD  - Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center and 
      Schneider Children's Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, 
      Tel Aviv University, Tel Aviv, Israel. Electronic address: 
      tzelnicksharon@gmail.com.
FAU - Soudry, Ethan
AU  - Soudry E
AD  - Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center and 
      Schneider Children's Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, 
      Tel Aviv University, Tel Aviv, Israel.
FAU - Raveh, Eyal
AU  - Raveh E
AD  - Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center and 
      Schneider Children's Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, 
      Tel Aviv University, Tel Aviv, Israel.
FAU - Gilony, Dror
AU  - Gilony D
AD  - Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center and 
      Schneider Children's Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, 
      Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
DEP - 20190225
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Endoscopy
MH  - Ethmoid Sinus/surgery
MH  - Ethmoid Sinusitis/*complications/diagnostic imaging/therapy
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Orbital Cellulitis/*etiology/*therapy
MH  - Recurrence
MH  - Retrospective Studies
MH  - Rhinitis/*complications/therapy
MH  - Seasons
MH  - Tomography, X-Ray Computed
OTO - NOTNLM
OT  - Periorbital cellulitis
OT  - Rhinosinusitis
OT  - Sinusitis complications
EDAT- 2019/03/12 06:00
MHDA- 2019/07/18 06:00
CRDT- 2019/03/12 06:00
PHST- 2018/11/27 00:00 [received]
PHST- 2019/02/18 00:00 [revised]
PHST- 2019/02/20 00:00 [accepted]
PHST- 2019/03/12 06:00 [pubmed]
PHST- 2019/07/18 06:00 [medline]
PHST- 2019/03/12 06:00 [entrez]
AID - S0165-5876(19)30102-8 [pii]
AID - 10.1016/j.ijporl.2019.02.037 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2019 Jun;121:26-28. doi: 
      10.1016/j.ijporl.2019.02.037. Epub 2019 Feb 25.