Clinical Pediatrics and Pediatric Surgery

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 dacryocystitis, 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 was done on children with a final discharge diagnosis of periorbital cellulitis from January 2009 to December 2014 at a tertiary care children’s 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 non-insect bite group more commonly had fever at presentation (p <0.001), with increased WBC and CRP 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.