Hospital-based study of causative organisms and clinical picture of orbital cellulitis secondary to sinusitis

Abstract

Objectives The aim of this study was to assess the behavior of orbital cellulitis secondary to sinusitis and the detection of the causative organisms in patients presenting to Cairo University Hospitals. Patients and methods This was a cohort study in which 43 cases diagnosed with orbital cellulitis secondary to sinusitis were admitted to hospital and were enrolled in the study. All patients underwent thorough ophthalmological examinations, ENT consultations, and systemic assessments. Coronal and axial computed tomography scans of orbit, paranasal sinuses, and brain were done for all patients. Some patients had specimen sent for culture and sensitivity from the drained pus either from sinuses or lid abscesses. Results A total of 43 cases were involved in this study. The mean age was 23.93±19.38 years. Seven patients had systemic medical disorders. Six patients were diabetic. All patients received antimicrobial treatment, with seven (16.2%) patients needing addition of antifungal treatment and seven (16.2%) patients needing addition of steroids. A total of 20 (46.5%) patients needed surgical intervention. From these patients who had a specimen sent for culture and sensitivity, five (11.6%) had bacterial infections, seven (16.3%) had fungal infections, and eight (18.6%) showed no growth. A total of 39 (90.7%) patients responded clinically to treatment and four patients had recurrence within 6 months. Conclusion Bacterial infection was the commonest cause of orbital cellulitis secondary to sinusitis in the current study. Diabetes mellitus was a predisposing factor to fungal infection, which had a poor prognosis, in which visual acuity reached no light perception.

Keywords

• antibiotics
• computed tomography
• culture
• orbital cellulitis
• sinusitis