The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Jia Shin Poon - One of the best experts on this subject based on the ideXlab platform.
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the management of Periorbital Cellulitis secondary to sinonasal infection a multicenter prospective study in the united kingdom
International Forum of Allergy & Rhinology, 2020Co-Authors: Sridhayan Mahalingam, Robert Hone, Gareth Lloyd, Robert Grounds, Eamon Shamil, Gentle Wong, Ali Allami, Anum Pervez, James Rudd, Jia Shin PoonAbstract:Background Periorbital Cellulitis is a potential sight-threatening complication of sinusitis. The majority of patients improve with medical management. Previous studies have suggested significant variations in practice and lack of evidence regarding the optimal management of this condition. Methods A prospective study was conducted over a 12-month period at 8 centers in the United Kingdom assessing the management of patients requiring inpatient treatment for Periorbital Cellulitis secondary to sinonasal infections. Results A total of 143 patients were recruited, of whom 40 were excluded. Of the remaining 103 patients, 5 (4.9%) were diagnosed with neurosurgical complications. This resulted in 98 patients admitted with Periorbital Cellulitis secondary to an upper respiratory tract infection/sinusitis. A total of 72 were children, of whom 12 (16.7%) required surgical intervention; and of 26 adults, 5 (19.2%) required surgery: the most common antimicrobial regimes administered were intravenous ceftriaxone (with or without metronidazole), and co-amoxiclav. The use of both ceftriaxone and metronidazole from admission was associated with the shortest duration of inpatient stay (3.8 days) in comparison to ceftriaxone alone (5.8 days) or co-amoxiclav (4.5 days) and a reduction in number of patients requiring surgical intervention. There was also an association between the early use of intranasal decongestants and steroids and reduction in requirement for surgical intervention. Conclusion For a condition where swab and blood cultures are often negative, this study supports the use of ceftriaxone in combination with metronidazole. The administration of intranasal decongestants and corticosteroids correlated with a smaller percentage of those progressing to surgery in those with and without Periorbital abscesses.
Melanie Duval - One of the best experts on this subject based on the ideXlab platform.
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daily outpatient intravenous antibiotic therapy for the management of paediatric Periorbital Cellulitis a retrospective case series
Clinical Otolaryngology, 2019Co-Authors: Ashley Tritt, Emily Kayrivest, Tiffany Paradis, Melanie DuvalAbstract:Objective To evaluate whether outpatient treatment of Periorbital Cellulitis with daily administration of intravenous antibiotics and physician evaluation is an effective and safe alternative to admission. Design A retrospective chart review study of paediatric patients treated on an outpatient basis for Periorbital Cellulitis at a tertiary children's hospital between 2013 and 2015 was performed. Children were assessed day by a paediatrician to monitor for resolution of symptoms or complications. Setting The Montreal Children's hospital, a tertiary care centre. Participants Children diagnosed with an uncomplicated Periorbital Cellulitis secondary to an acute sinusitis or upper respiratory tract infection. Main outcome measures The number of days of intravenous antibiotics, complications or need for subsequent admission. Complications were defined as formation of an abscess or phlegmon confirmed on computerised tomography scan, worsening or recurrent persistent Cellulitis, failure to improve on intravenous antibiotics, and intracranial complications. Results Sixty-six children with a diagnosis of uncomplicated Periorbital Cellulitis secondary to sinusitis who received intravenous antibiotics via medical day hospital and who fit the inclusion criteria were identified. The mean duration of intravenous antibiotic therapy was 4.1 days. All children received ceftriaxone, with one patient also receiving cefuroxime. Two of 66 patients developed complications; one patient required admission for failure to improve/subperiosteal phlegmon and later underwent functional endoscopic sinus surgery, and one patient developed an eyelid abscess that did not require admission. No patients developed severe neurological or visual deficits. Conclusions Outpatient intravenous therapy with daily reassessment by a physician may be a safe alternative to admission in select cases of Periorbital Cellulitis without systemic signs of illness.
Horst Von Bernuth - One of the best experts on this subject based on the ideXlab platform.
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Scabies, Periorbital Cellulitis and Recurrent Skin Abscesses due to Panton-Valentine Leukocidin-Positive Staphylococcus aureus Mimic Hyper IgE Syndrome in an Infant.
Pediatric Infectious Disease Journal, 2017Co-Authors: Renate Krüger, Leif G. Hanitsch, Rasmus Leistner, Sylke Schneider-burrus, Pia-alice Hoppe, Sylvia Steinberg, Fabian Hauck, Horst Von BernuthAbstract:: We describe the clinical course of a 2-month-old infant who was evaluated for autosomal dominant Hyper IgE Syndrome based on eczema, Periorbital Cellulitis, skin abscesses, increased total IgE levels and blood eosinophilia. However, scabies and nasal colonization by Panton-Valentine Leucocidin-positive S. aureus were eventually diagnosed. After specific treatment, the child was asymptomatic.
Sridhayan Mahalingam - One of the best experts on this subject based on the ideXlab platform.
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the role of adjuvant systemic steroids in the management of Periorbital Cellulitis secondary to sinusitis a systematic review and meta analysis
European Archives of Oto-rhino-laryngology, 2021Co-Authors: Sridhayan Mahalingam, Louis Luke, Jyotsna Pundir, Vishal PundirAbstract:The role of adjuvant systemic corticosteroids in the management of Periorbital Cellulitis and subperiosteal/orbital abscesses secondary to sinonasal infections is not well understood. Our objective was to systematically review the current evidence on the efficacy and side effects of systemic steroids when used in the management of Periorbital Cellulitis. A systematic review of literature was conducted in accordance with PRISMA guidance. A systematic search of MEDLINE, Embase and Cochrane databases, MetaRegister and ISI conference proceedings was conducted. The outcomes of interest were duration of inpatient stay, requirement for surgical intervention, adverse effects and recurrent/residual symptoms. Four studies were identified involving 118 patients. Of these, 78 underwent treatment with systemic corticosteroids and 40 were controls. Meta-analysis demonstrated that the mean duration of inpatient stay was significantly shorter in the steroid group (WMD − 2.90 days; 95% CI − 3.07, − 2.73; p < 0.00001). There were no significant differences in requirement for surgical intervention (RR 0.93; 95% CI 0.50, 1.75; p = 0.83). Side effects were reported in 6/78 patients (7.7%), with 5 patients showing signs of hyperactivity and 1 patient with insomnia. These were mild except in one case, which required early cessation of corticosteroids. There was one case of recurrence of symptoms in each cohort (steroid vs. non-steroid) following discharge. The evidence suggests that systemic corticosteroids may offer some benefit in the management of Periorbital Cellulitis secondary to sinonasal infections. However, there is significant heterogeneity and risk of bias. A well-designed randomised controlled trial may provide a better insight into the efficacy of systemic steroids for this condition.
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the management of Periorbital Cellulitis secondary to sinonasal infection a multicenter prospective study in the united kingdom
International Forum of Allergy & Rhinology, 2020Co-Authors: Sridhayan Mahalingam, Robert Hone, Gareth Lloyd, Robert Grounds, Eamon Shamil, Gentle Wong, Ali Allami, Anum Pervez, James Rudd, Jia Shin PoonAbstract:Background Periorbital Cellulitis is a potential sight-threatening complication of sinusitis. The majority of patients improve with medical management. Previous studies have suggested significant variations in practice and lack of evidence regarding the optimal management of this condition. Methods A prospective study was conducted over a 12-month period at 8 centers in the United Kingdom assessing the management of patients requiring inpatient treatment for Periorbital Cellulitis secondary to sinonasal infections. Results A total of 143 patients were recruited, of whom 40 were excluded. Of the remaining 103 patients, 5 (4.9%) were diagnosed with neurosurgical complications. This resulted in 98 patients admitted with Periorbital Cellulitis secondary to an upper respiratory tract infection/sinusitis. A total of 72 were children, of whom 12 (16.7%) required surgical intervention; and of 26 adults, 5 (19.2%) required surgery: the most common antimicrobial regimes administered were intravenous ceftriaxone (with or without metronidazole), and co-amoxiclav. The use of both ceftriaxone and metronidazole from admission was associated with the shortest duration of inpatient stay (3.8 days) in comparison to ceftriaxone alone (5.8 days) or co-amoxiclav (4.5 days) and a reduction in number of patients requiring surgical intervention. There was also an association between the early use of intranasal decongestants and steroids and reduction in requirement for surgical intervention. Conclusion For a condition where swab and blood cultures are often negative, this study supports the use of ceftriaxone in combination with metronidazole. The administration of intranasal decongestants and corticosteroids correlated with a smaller percentage of those progressing to surgery in those with and without Periorbital abscesses.
Sam J Daniel - One of the best experts on this subject based on the ideXlab platform.
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Periorbital Cellulitis in the pediatric population clinical features and management of 117 cases
Journal of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Sami P Moubayed, Caroline Quach, Sam J DanielAbstract:Objective Since the advent of the Haemophilus influenzae type B vaccine, no North American case series has described Periorbital Cellulitis extensively as the main focus in the otolaryngology literature has been the management of orbital abscesses. The aim of this study was to describe the epidemiology, underlying causes, clinical presentation, and medical management of Periorbital Cellulitis. Study design Retrospective observational case series. Setting Montreal Children's Hospital, McGill University Health Centre, a tertiary pediatric referral center in Montreal, Quebec. Subjects and methods The medical charts of all pediatric patients hospitalized from January 2000 to August 2006 with a discharge ICD-9 code indicating a diagnosis of Periorbital Cellulitis without abscess were reviewed. One hundred seventeen cases were identified. Results Periorbital Cellulitis in the pediatric population affects mainly preschool-aged patients (mean age 4.1 ± 4.2 years [SD]) and is more frequent among males than females (1.3:1). The most common predisposing conditions are sinusitis (24.8%), trauma (23.1%), and ocular conditions (13.7%). All patients were successfully managed with intravenous antibiotics for a mean period of 3.4 ± 2.6 days and oral antibiotics for 8.1 ± 4.4 days and recovered fully without complications. Conclusion Our results are consistent with the literature on the subject and show that timely identification of Periorbital Cellulitis cases and appropriate medical management result in resolution of the condition without complications.