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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
Tristan Manalac, 14 May 2020
Liver injuries appear to be more common in severe cases of coronavirus disease 2019 (COVID-19), a new meta-analysis reports.
19 May 2020
Upper respiratory (UR) and atypical symptoms are more likely to occur in children with symptomatic pharyngitis and group A Streptococcus (GAS) on throat culture identified as carrier than those who are acutely infected, according to a study.
16 May 2020
There appears to be no evidence of the SARS-CoV-2 virus in the semen of patients recovering from COVID-19 a month after diagnosis, according to a study, suggesting that the virus is unlikely to gain entry into testicular cells through an ACE2/TMPRSS2-mediated mechanism.
Stephen Padilla, 19 May 2020
Influenza A and B infections show comparable clinical severity in children, a study has shown.