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Extraorbital cellulite in children
Last reviewed: 23.04.2024
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Extraorbital cellulite is characterized by localization of the inflammatory process in front of the tarzorbital fascia, which prevents the spread of infection into the orbit.
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The cause of extraorbital cellulitis in children
- Inflammatory diseases of the eyelids (for example, herpes simplex), acute blepharitis, infected chalazion, impetigo, abscesses of the skin.
- Dacryocystitis.
- Trauma, accompanied by purulent cellulite, caused by Staph. Aureus and Streptococcus.
- Infections of the upper respiratory tract of streptococcal genesis and influenza with hemorrhagic syndrome (especially characteristic for young children).
Symptoms of extraorbital cellulitis in children
The disease is usually manifested by unilateral edema of the eyelids, fever, leukocytosis. Often local pathology is revealed: chalaziona, dacryocystitis, etc. There may be lacrimation and discharge from the conjunctival cavity.
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Treatment of extraorbital cellulitis in children
In most cases, treatment is performed in the hospital, coordinating appointments with a pediatrician and / or infectious disease specialist.
Antibiotic therapy
When staining the causative agent according to Gram, a specific therapy is prescribed corresponding to the revealed sensitivity. It is not recommended to begin treatment until the results of laboratory tests, including a blood test.
In cases where the disease is a consequence of trauma, the use of oxacillin or nafcillin in a daily dose of 150-200 mg / kg body weight is indicated. If an upper respiratory tract infection is attached, cefuroxime is administered at a daily dose of 100-150 mg / kg bodyweight or a combination of ampicillin at a daily dose of 50-100 mg / kg and chloramphenicol at a daily dose of 75-100 mg / kg body weight. In some countries, chloramphenicol is not approved for use because of the potential for side effects. In any case, the treatment starts with intravenous administration of the selected drug. After receiving the results of the study of scraping from the affected tissue and bacteriological examination of the blood, and also in the absence of the full effect of the therapy, the antibiotic used can be changed.
The need for drainage of the abscess arises rarely. Surgery is indicated only in cases where after several days of intensive antibiotic treatment there is no positive dynamics.