Periorbital and orbital cellulitis in the haemophilus influenzae vaccine era

• Published in: Journal of pediatric ophthalmology and strabismus Vol. 34; no. 5; pp. 293 - 296
• Main Authors: BARONE, S. R, AIUTO, L. T
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01.09.1997; SLACK INCORPORATED
• Subjects: Adolescent; Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Cellulitis - diagnostic imaging; Cellulitis - microbiology; Cellulitis - prevention & control; Child; Child, Preschool; Eye Infections, Bacterial - diagnostic imaging; Eye Infections, Bacterial - etiology; Eye Infections, Bacterial - prevention & control; Haemophilus Infections - diagnostic imaging; Haemophilus Infections - etiology; Haemophilus Infections - prevention & control; Haemophilus influenzae - isolation & purification; Haemophilus Vaccines - administration & dosage; Human bacterial diseases; Humans; Infant; Infectious diseases; Medical sciences; Orbit - diagnostic imaging; Orbit - microbiology; Orbital Diseases - diagnostic imaging; Orbital Diseases - microbiology; Orbital Diseases - prevention & control; Radiography; Retrospective Studies; Sinusitis - diagnostic imaging; Sinusitis - microbiology; Sinusitis - prevention & control; Human; Skin disease; Vaccination; Orbit(eye) disease; Cellulitis; Orbit(eye); Bacteriological investigation; Bacteremia; Haemophilus influenzae; Infection; Pasteurellaceae; Eye disease; Etiology; Bacteriosis; Bacteria; Child
• ISSN: 0191-3913; 1938-2405
• DOI: 10.3928/0191-3913-19970901-08

Prior to development of the Haemophilus-influenzae vaccine, a significant number of periorbital and orbital infections were associated with H influenzae type b bacteremia. The incidence of invasive H influenzae type b disease has decreased dramatically since the introduction of these vaccines. The effect of the H influenzae type b vaccine on the microbiology of periorbital and orbital infections has not been examined. Charts of 134 hospitalized patients with the discharge diagnosis of periorbital or orbital cellulitis from 1985 to 1995 were reviewed. In contrast with studies performed in the pre-vaccine era, H influenzae type b was not a significant pathogen. The pathogen was isolated from only 2 of 133 blood cultures performed, and was not isolated from any of the 101 patients discharged after July 1987. Sinusitis, however, remains an important cause of these eye infections. Of patients who underwent radiographic evaluation, sinusitis was present in 96% of children with orbital cellulitis and 81% of patients with periorbital cellulitis. H influenzae type b is no longer a significant pathogen in periorbital or orbital cellulitis and management should be modified accordingly.