TY - JOUR
T1 - Are We Over-Treating Insect Bite Related Periorbital Cellulitis in Children? The Experience of a Large, Tertiary Care Pediatric Hospital
AU - Friedel, Nadav
AU - Scolnik, Dennis
AU - Rimon, Ayelet
AU - Orbach, Rotem
AU - Laat, Sharon
AU - Glatstein, Miguel M.
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction:Preseptal (periorbital) and orbital cellulitis are potentially catastrophic infections near the eye. Preseptal cellulitis is far more common, and although classically reported to be associated with dacrocystitis, sinusitis/upper respiratory infection, trauma/surgery, or infection from contiguous areas, it can also be associated with insect bites. The objective of this study was to determine the prevalence of insect bite-associated preseptal cellulitis and to compare clinical findings and outcomes of these patients with those having other causes for the condition.Methods:Retrospective chart review of children with a final discharge diagnosis of periorbital cellulitis from January 2009 to December 2014 at a tertiary care children' hospital.Results:213 children were diagnosed with preseptal cellulitis during the 5-year study period, of whom 60 (28%) were associated with insect bites. Patients in the noninsect bite group more commonly had fever at presentation (P < 0.001), with increased white blood cell and C reactive protein values (both P < 0.001). No patient with insect bite-associated preseptal cellulitis presented with fever, and none underwent radiographic testing or computerized tomography; their mean age was also lower (P < 0.001) and length of stay was significantly shorter.Conclusions:This study suggests that children with preseptal cellulitis associated with insect bites could be candidates for oral antibiotic therapy with outpatient follow-up by.
AB - Introduction:Preseptal (periorbital) and orbital cellulitis are potentially catastrophic infections near the eye. Preseptal cellulitis is far more common, and although classically reported to be associated with dacrocystitis, sinusitis/upper respiratory infection, trauma/surgery, or infection from contiguous areas, it can also be associated with insect bites. The objective of this study was to determine the prevalence of insect bite-associated preseptal cellulitis and to compare clinical findings and outcomes of these patients with those having other causes for the condition.Methods:Retrospective chart review of children with a final discharge diagnosis of periorbital cellulitis from January 2009 to December 2014 at a tertiary care children' hospital.Results:213 children were diagnosed with preseptal cellulitis during the 5-year study period, of whom 60 (28%) were associated with insect bites. Patients in the noninsect bite group more commonly had fever at presentation (P < 0.001), with increased white blood cell and C reactive protein values (both P < 0.001). No patient with insect bite-associated preseptal cellulitis presented with fever, and none underwent radiographic testing or computerized tomography; their mean age was also lower (P < 0.001) and length of stay was significantly shorter.Conclusions:This study suggests that children with preseptal cellulitis associated with insect bites could be candidates for oral antibiotic therapy with outpatient follow-up by.
KW - insect bite
KW - pediatric
KW - periorbital cellulitis
KW - preseptal cellulitis
UR - http://www.scopus.com/inward/record.url?scp=85047072927&partnerID=8YFLogxK
U2 - 10.1097/MJT.0000000000000596
DO - 10.1097/MJT.0000000000000596
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C2 - 28452841
AN - SCOPUS:85047072927
SN - 1075-2765
VL - 26
SP - e1-e4
JO - American Journal of Therapeutics
JF - American Journal of Therapeutics
IS - 1
ER -