Objective: To analyze the clinical characteristics, causative pathogens, complications, and treatment outcomes of orbital cellulitis in children. Methods: A retrospective cohort study was performed. Clinical data including clinical characteristics, laboratory tests, pathogen profiles, and treatment were analyzed for 175 pediatric patients with orbital cellulitis admitted to Beijing Children's Hospital, Capital Medical University from January 2016 to December 2023. Patients were categorized by lesion location into periorbital cellulitis (PC) and orbital cellulitis (OC) groups; by complication status into with and without complications. Intergroup comparisons were performed using the chi-square test and Mann-Whitney U test. Logistic regression analysis was used to identify risk factors for complications. Results: Of the 175 patients, 116 were male and 59 were female, with an age at presentation of 3.6 (2.1, 6.7) years. There were 81 patients in the PC group and 94 in the OC group. All patients presented with eyelid and periorbital erythema and edema. The OC group demonstrated higher proportions of males, sinusitis, proptosis, ocular motility disorders, bulbar conjunctival edema, and decreased visual acuity compared to the PC group, C-reactive protein levels, neutrophil counts, and platelet counts in the acute phase were also significantly higher in the OC group (all P<0.05). A definitive microbiological diagnosis was established in 74 cases (42.3%), and a total of 76 pathogenic strains were isolated. The most common pathogen was Staphylococcus aureus, accounting for 47 strains (61.8%), including 33 strains (43.4%) of methicillin-susceptible Staphylococcus aureus, and 14 strains (18.4%) of methicillin-resistant Staphylococcus aureus, followed by Streptococcus intermedius and Streptococcus constellatus with 6 strains each (7.9%), and Streptococcus pneumoniae and Pseudomonas aeruginosa with 4 strainss each (5.3%). Complications developed in 47 cases (26.8%), most commonly orbital abscesses in 29 cases (16.6%), followed by purulent meningitis in 14 cases (8.0%). Multivariate logistic regression analysis identified proptosis (OR=3.56, 95%CI 1.49-8.49), decreased visual acuity (OR=4.45, 95%CI 1.27-15.66), and headache (OR=2.76, 95%CI 1.01-7.57) as independent risk factors for complications (all P<0.05). Conclusions: Orbital cellulitis in children commonly presents with eyelid and periorbital redness and swelling. Male sex, sinusitis, proptosis, ocular motility disorders, bulbar conjunctival edema, and decreased vision acuity serve as high-risk indicators for orbital cellulitis. Elevated C-reactive protein, neutrophil count, and platelet counts in the acute phase are laboratory makers closely associated with orbital cellulitis. Staphylococcus aureus is the most common causative pathogen. Decreased vision acuity, proptosis, and headache suggest the presence of complications. 目的： 分析儿童眶蜂窝织炎的临床特点、致病菌种类、并发症及治疗情况。 方法： 回顾性病例队列研究。分析2016年1月至2023年12月首都医科大学附属北京儿童医院收治的175例眶蜂窝织炎患儿的临床特征、实验室检查、病原学特征、治疗等临床资料。根据病变部位分为眶隔前蜂窝织炎（PC）组和眶内蜂窝织炎（OC）组，根据有无并发症分为有并发症组和无并发症组。组间比较采用χ²检验、Mann-Whitney U检验，应用Logistic回归分析合并并发症的危险因素。 结果： 175例患儿中，男116例、女59例，就诊年龄3.6（2.1，6.7）岁。PC组81例、OC组94例。所有患儿均存在眼睑及眶周红肿。OC组患儿男性、鼻窦炎、眼球突出、眼球运动障碍、球结膜水肿、视力下降的比例及急性期C反应蛋白、中性粒细胞计数、血小板计数水平均高于PC组（均P<0.05）。74例（42.3%）患儿明确病原学诊断，共分离出76株致病菌，常见的致病菌为金黄色葡萄球菌47株（61.8%），耐甲氧西林金黄色葡萄球菌 33株（43.4%），耐甲氧西林金黄色葡萄球菌 14株（18.4%），中间链球菌、星座链球菌各6株（7.9%），肺炎链球菌、铜绿假单胞菌各4株（5.3%）。47例（26.8%）患儿出现并发症，常见的并发症依次为眼眶脓肿29例（16.6%），化脓性脑膜炎14例（8.0%）。多因素Logistic回归分析示眼球突出（OR=3.56，95%CI 1.49~8.49）、视力下降（OR=4.45，95%CI 1.27~15.66）、头痛（OR=2.76，95%CI 1.01~7.57）均是存在并发症的独立危险因素（均P<0.05）。 结论： 儿童眶蜂窝织炎常见眼睑及眶周红肿，其中男性、存在鼻窦炎、眼球突出、眼球运动障碍、球结膜水肿、视力下降为OC的高危提示指标。急性期C反应蛋白、中性粒细胞计数、血小板值升高是与OC高度相关的实验室指标。金黄色葡萄球菌是常见的病原菌。视力下降、眼球突出、头痛患儿可能合并并发症。.
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PubMed · 2026-08-02
PubMed · 2026-08-02
PubMed · 2026-08-02