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Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 2/2024

18.10.2023 | Oculoplastics and Orbit

Pediatric orbital subperiosteal abscess outbreak in Iran: characteristics and causes

verfasst von: Pedram Afshar, Amirhossein Aghajani, Navid Mohsenzadeh, Mostafa Heidari, Seyed Mohsen Rafizadeh, Zohreh Abedinifar, Mohammad Taher Rajabi

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 2/2024

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Abstract

Purpose

To evaluate demographics, characteristics, and management of pediatric patients with subperiosteal abscesses (SPA) secondary to orbital cellulitis and discuss the etiology of a dramatic rise in SPA.

Methods

Data were gathered by retrospective chart review of patients admitted to a tertiary referral eye hospital (Farabi Eye Hospital) diagnosed with orbital cellulitis with subperiosteal abscess from October 2022 to March 2023 (six months). Data on demographic information, clinical examination, radiographic evidence of sinusitis, orbital cellulitis, SPA, surgical and non-surgical management taken, isolated bacteria, and duration of hospital stay were gathered.

Results

24 patients were admitted during these six months, with a diagnosis of orbital SPA secondary to paranasal sinusitis, confirmed by an orbital Computed Tomography (CT) scan. The age range was 11 months to 16 years. 75% of patients were male. All patients had a history of flu-like illness before developing orbital cellulitis. All patients had concurrent sinusitis, and 18 underwent initial surgical abscess drainage. The ethmoid sinus was the most involved, and most patients had a medially located SPA. Abscess volume ranged from 0.78 to 7.81 cm3 (mean: 3.52 cm3). One patient had concurrent central retinal artery occlusion due to orbital cellulitis.

Conclusions

In this study, we report a dramatic increase in the incidence of SPA referred to our hospital. Larger abscess volumes and an increased number of cases that needed initial surgical drainage are also of note. An influenza outbreak in the autumn and winter, undiagnosed Corona Virus Disease 2019 (COVID-19) infection, increased antimicrobial resistance due to excessive off-label use of antibiotics during the COVID-19 pandemic, and more virulent bacterial infections are the most probable hypotheses to justify this observation.
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Metadaten
Titel
Pediatric orbital subperiosteal abscess outbreak in Iran: characteristics and causes
verfasst von
Pedram Afshar
Amirhossein Aghajani
Navid Mohsenzadeh
Mostafa Heidari
Seyed Mohsen Rafizadeh
Zohreh Abedinifar
Mohammad Taher Rajabi
Publikationsdatum
18.10.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 2/2024
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-023-06266-z

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