Manifestations of fungal cellulitis of the orbit in children with neutropenia and fever.

Abstract:

PURPOSE:To delineate clinical manifestations of fungal orbital cellulitis in immunocompromized patients. METHODS:The charts of 7 pediatric patients with fungal orbital cellulitis treated at a tertiary children's cancer hospital were reviewed retrospectively for histologically confirmed fungal sinusitis with associated orbital cellulitis. Patients underwent CT and/or MRI of the orbits, sinuses, and brain; surgery; and therapy with antifungal medications. Main outcome measures were presenting signs and patient survival. RESULTS:Twenty-four patients with fungal sinusitis were identified, 7 of whom (4 months to 15 years of age) had documented orbital fungal cellulitis. All 7 patients presented with neutropenia and fever. Presenting symptoms included edema of the upper eyelid (n=4), headache (n=1), and facial pain (n=1). One patient was asymptomatic. Although antifungal therapy was initiated within 24 hours of presentation, disease progressed, and 5 patients eventually died of their infections. CONCLUSIONS:Because fungal orbital cellulitis can be fatal even if detected early in patients who are immunocompromised, ophthalmologists and otolaryngologists should be alert to the disease's subtle clinical manifestations.

authors

McCarty ML,Wilson MW,Fleming JC,Thompson JW,Sandlund JT,Flynn PM,Knapp KM,Haik BG,Ribeiro RC

doi

10.1097/01.iop.0000124677.03668.d7

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

217-23

issue

3

eissn

0740-9303

issn

1537-2677

pii

00002341-200405000-00008

journal_volume

20

pub_type

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