Orbital Cellulitis in Children: Experience of the Pediatric Service at Mohammed v Military Hospital

Abstract

Background: Orbital cellulitis is a diagnostic and therapeutic emergency, jeopardizing the  vital and functional prognosis. This study aimed to analyze the epidemiological, therapeutic and evolutional aspects of orbital cellulitis cases treated at the pediatric service at Mohamed V military hospital. Patients and methods: retrospective study including all the children aged between 1 month and 15 years treated for orbital cellulitis at the pediatric service of the Mohamed V Hospital over a period of 3 years (1st January 2016-31st December 2019). Results: 24 cases of orbital cellulitis were gathered. Age varied between 1 month and 15 years with a median of age of 6. years. Feminine predominance (58%) was noted . The disease mainly involved the sinus (32%).Clinically, fever was present in 10 patients (41%),palpebral edema was universal, proptosis was noted in 5 cases(20.8%),chemosis and ptosis were noted in 4 cases(16.6%),bacteriological testing identified micro-organisms in 3 cases. An orbital CT scan was performed in all cases of our study, showing preseptal cellulitis in 14 cases (58.3%), orbital cellulitis in 3 cases(12.5%),and orbital abscess in 7 cases. The medical treatment consisted of ceftriaxone, metronidazole and aminoside or amoxicilline clavulanic acid, corticosteroid therapy prescribed in 5 cases. Surgical treatment was indicated in 3 patients. The outcome of All cases was favorable. Conclusion: The majority of our cases had a positive evolution highlighting the advantage of an early diagnosis, and adapted antibiotic and a multidisciplinary patient care making the need for surgery rarely necessary.