Infantile orbital abscess: clinical presentation, microbiological profile, and management outcomes

Abstract

ABSTRACT Purpose Orbital abscesses in children are not uncommon. Unless managed in a timely fashion, they can potentially lead to vision-threatening as well as life-threatening complications. The objective of this study is to report the clinical and microbiological profile and management outcomes in infants presenting with orbital abscesses. Materials and Methods A retrospective review of electronic medical records of children younger than 1 year with a diagnosis of an orbital abscess was done. The data was collected from a time period of 12 years (2007–2019). The data collected included mode of presentation, radiological, microbiological and histopathological features, and the final outcome. Results A total of nine patients met the inclusion criteria. The mean age at presentation was19 weeks. Three patients had upper respiratory tract infection, one had a congenital nasolacrimalduct obstruction, two had sinusitis, and one patient had neonatal sepsis. All patients underwentimaging following which abscess drainage was performed. Methicillin-sensitive Staphylococcusaureus was the most common organism, which was isolated in five patients, Methicillin-resistantS. aureus was isolated in three, while one patient had Entomophthorales fungal infection. Themedian follow-up period was 10 months (range 5 days to 89 months). There was no recurrencein the cohort. At least one patient had visual impairment at the last follow up. Conclusion Orbital abscesses in infants are rare. Imaging and prompt drainage of the abscess supplemented by appropriate antimicrobial regimen leads to a successful outcome.