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Cellulite of orbit in children
Last reviewed: 23.04.2024
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Cellulite of the orbit occurs when the inflammatory focus is located behind the tarzorbital fascia. Can be combined with extraorbital cellulite.
[The cause of cellulitis in children
- Injury.
- Foreign body.
- The consequence of surgical intervention.
- Hematogenous, due to a common infectious disease.
- Secondary, with respect to the necrotic neoblastome.
- Rhinogenic.
Pathogens
- H. Influenzae in newborns.
- Staph. Aureus.
- Strep. Pyogenes and Strep. Pneumoniniae.
- E. Coli.
- Fungi and molds (in children with suppressed immunity and diabetes).
Symptoms of Cellulite Orbit in Children
- Exophthalmos.
- Pain.
- Edema of the eyelids.
- Low vision.
- Chemosis.
- Limitation of mobility of the eyeball.
- Increased temperature and general malaise.
- Neuropathy of the optic nerve, leading to its atrophy.
- Keratitis associated with the exposure of the cornea caused by exophthalmos.
- Thrombosis of the central artery of the retina.
- Subperiosteal abscess in combination with sinusitis.
- Absence of orbit.
- Thrombosis of the cavernous sinus.
- Meningitis.
- Abscess of the brain.
- Septicemia.
Where does it hurt?
What do need to examine?
How to examine?
Treatment of cellulite of orbit in children
The patient must be hospitalized.
Research
- For staining by Gram and determining the sensitivity of the pathogen to antibiotics, a smear is taken:
- with conjunctiva;
- from the nasopharynx.
- Radiography of the paranasal sinuses.
- CT to evaluate the degree of involvement in the pathological process of the orbit and to diagnose orbital and subperiosteal abscesses.
- Inspection of the otolaryngologist.
- If necessary, see the dentist.
- Search for a source of inflammation in other organs.
- If suspected of having meningitis, a lumbar puncture should be performed.
- Sowing blood for sterility.
Research is recommended in conjunction with a pediatrician and infectious disease specialist.
- In cases where Gram staining can identify a particular pathogen, in anticipation of the results of other studies, antibiotic treatment is prescribed taking into account the sensitivity of the microflora.
- In those cases when the pathogen of the inflammatory process can not be detected, it is possible:
- intravenous chloramphenicol (daily dose 75-100 mg / kg body weight) with ampicillin (daily dose of 150 mg / kg body weight);
- cefalosporins, for example ceftazidime (a daily dose of 100-150 mg / kg body weight) or ceftriaxone (a daily dose of 100-150 mg / kg body weight) in combination with nafcillin (nafcillin) or oxacillin (daily dose of 150/200 mg / kg body weight).
You may need to drain the abscess.
It is not recommended to prescribe a child from a medical institution until full recovery. Antibiotic therapy is continued at least within a week after the normalization of temperature and the emergence of positive dynamics. If you do not adhere to these principles or treat with inappropriate doses of antibiotics, there may be an exacerbation of the disease, development of osteomyelitis and other complications.
It is important to remember that the possibility of complications persists even when the clinical symptomatology subsides. By changing the reaction of the pupil, one can assume the development of the optic nerve neuropathy or the pathology of the retinal vessels; long-existing exophthalmos require serial CT scans.