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Older age, disease severity tied to treatment failure in children with orbital complications of ARS

02 Oct 2019

In children admitted for orbital complications of acute rhinosinusitis (ARS), the most important causes of medical treatment failure are older age and stage II/III orbital complications at presentation, a recent study has shown.

“Early referral to eye, nose and throat (ENT) should be considered for children [aged] >5 years with ARS due to worse orbital complications despite prehospital antibiotics,” the authors said.

Two-thirds of the children had received antibiotics prior to hospital admission, but half of the cohort still presented with postseptal orbital complications. Eighty-three percent of isolates obtained from the same patients were susceptible to the prehospital antibiotics they received, but majority of these children still needed to undergo surgery.

A significant association existed between disease severity and the age of presentation. Despite prehospital antibiotics, more severe orbital complications occurred in children aged >5 years. This cohort was also more likely to require surgical intervention (p<0.001).

This retrospective cohort study characterized the clinical outcomes of 61 children admitted for orbital complications between 1 January 2002 and 31 December 2017 and identified risk factors associated with disease severity. The authors performed descriptive statistics to analyse the demographics and clinical findings. They also used Mann-Whitney U test for continuous variables and χ2 for categorical variables to compare groups.

“The major clinical dilemma managing ARS in paediatric population is distinguishing uncomplicated rhinosinusitis from a complicated bacterial ARS and orbital complications, the latter requiring antimicrobials and surgical intervention,” the authors noted.

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Most Read Articles
21 Sep 2020
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 21 Sep 2020
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
2 days ago
Percutaneous coronary intervention (PCI), compared with coronary artery bypass grafting (CABG), in the revascularization of left main coronary artery (LMCA) disease may lead to death, myocardial infarction (MI), or stroke in patients with moderate or severe left ventricular (LV) dysfunction, reveals a study.