Recurrent periorbital cellulitis and otitis media in an asthmatic child with chronic diarrhea and short stature

Recurrent Periorbital Cellulitis Secondary to Cyclic Neutropenia

Purpose:

To present a 1-year-old boy with cyclic neutropenia who presented with multiple episodes of periorbital cellulitis (POC).

Methods:

The child presented with three episodes of POC. In the second episode, the cellulitis was associated with nasolacrimal duct obstruction, and in the third episode, a pansinusitis was noted. He underwent a thorough systemic evaluation.

Results:

Patient's evaluation revealed the diagnosis of cyclic neutropenia.

Conclusion:

This report emphasizes the possibility of an underlying immunodeficiency with recurrent POC, even in an apparently healthy child.

Recurrent Periorbital Cellulitis: An Unusual Clinical Entity

OBJECTIVES: To discuss the cause and management of recurrent periorbital cellulitis (RPOC).

STUDY DESIGN: Retrospective case series and review of literature.

MATERIALS AND METHODS: In the past 11 years, we have treated 6 patients for recurrent periorbital cellulitis (RPOC). Inclusion criteria were a minimum of 3 episodes of periorbital cellulitis (POC) within a 1-year period, with interval convalescence lasting at least 1 month. All patients were followed for at least 1 year after resolution.

RESULTS: The causes of RPOC were as follows: (1) 2 patients developed RPOC attributed to environmental allergies; (2) 1 was diagnosed with underlying recurrent sinusitis resistant to medical management with resolution attained through surgery; (3) 1 patient with vesicular RPOC was diagnosed with herpetic RPOC and treated medically with antiviral therapy; (4) 1 patient had allergic contact dermatitis from cosmetic make-up use; and (5) 1 patient was suspected of malingering via repeat subcutaneous self-injection of an irritant.

CONCLUSIONS: Although periorbital cellulitis is a commonly encountered and treatable condition, recurrent periorbital cellulitis is rare and may be challenging to manage. In our experience, the causes of recurrence varied, but resolution was achieved by identifying the underlying cause through continuous clinical reassessment and by appropriate medical or surgical management.

EBM rating: C-4

Recurrent periorbital cellulitis in a very young child: a case report and review of literature

Recurrent periorbital cellulitis is a rare complication of sinus disease. We present a 4-month-old boy with bilateral recurrent periorbital cellulitis and radiological evidence of bilateral bony dehiscence of the lamina papyracea. To our knowledge, this is the youngest documented presentation of recurrent periorbital cellulitis. As well, only unilateral cases have been reported in the past. In addition to the clinical case report, we reviewed the current literature available regarding recurrent periorbital cellulitis.

Recurrent unilateral periorbital cellulitis in a pediatric patient--an anatomic abnormality

A 2-year-old male, otherwise healthy, suffered a total of 7 episodes of recurrent right-sided periorbital celluitis (POC) which began at 11 months of age. Five of the 7 episodes of right eye swelling/erythema required hospital admission for intravenous antibiotics. Imaging studies demonstrated a well-defined dehiscence in the lamina papyracea. Endoscopic sinus surgery was performed and an abnormal uncinate process was visualized, fused to the lateral nasal wall and ethmoid bulla. Post-operatively, the patient had no further infections. Nasal endoscopy and high-resolution imaging in pediatric patients with recurrent POC could identify those who would benefit from early surgical intervention.