Orbital cellulitis in a tertiary institution in Nigeria: Improving outcomes

Abstract

Background: Orbital infections could have untowards associated ocular and systemic morbidity. There is a need to reduce these complications to the barest minimum. Objectives: To improve outcomes of orbital cellulitis in Osogbo and suggest how to prevent complications. Materials and Methods: A 10-year retrospective study was conducted between 2003 and 2013 on cases admitted to the eye wards of LAUTECH Teaching Hospital, Osogbo, Nigeria. Clinical and sociodemographic data were extracted from the case notes. Data were entered into and analyzed with SPSS version 17 using descriptive statistics. Result: Of the 31 patients admitted for the treatment of orbital cellulitis, 20 (64.52%) were males and 11 (35.48%) were females. The age ranged between 2 and 85 years with a mean of 18.4 + 9.21 years, with 18 (56.06%) aged less than 20 years. The predisposing factors were mainly sinogenic, 18 (58.06%). Maxillary sinus constituted six (33.3%) whereas trauma and local spread constituted six (19.1%) each. Staphylococcus aureus was the only organism cultured in three (42.86%) whereas the remaining (57.14%) showed no growth. Complications recorded were orbital abscess in four and three each of panophthalmitis and optic atrophy. No death was recorded. Commonest surgery performed was bilateral intranasal anthrostomy in eight (25.8%) and drainage of orbital abscess. Visual acuity improved in four cases after treatment from blindness and visual impairment category to normal vision. Conclusion: The commonest cause of orbital infections was from adjacent sinus-related diseases. The problem of negative cultures still persists possibly due to indiscriminate use of antibiotics by the patients. Early presentation, effective antibiotics, and comanagement with other specialists improved outcome. No mortality was recorded.