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M.G. Wood, R. Mitchell, G. Overturf, F. Rupp, B. Hart, M.L. Schluter, P. Watkins; Optic Nerve Atrophy, Diplopia, and Cerebritis as Complications of Bilateral Orbital Cellulitis in Children Ages Eleven to Thirteen . Invest. Ophthalmol. Vis. Sci. 2003;44(13):639.
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Purpose: To report a constellation of clinical findings associated with bilateral orbital cellulitis, a rare life-threatening infection. Methods: Three children aged 11 to 13 years presented with bilateral eyelid edema and decreased motility associated with an upper respiratory infection and bilateral sinus infections. Successive MRI scans of the brain and orbits were used to follow the clinical progression following aggressive surgical drainage and IV antibiotic therapy. Results: Two patients developed a life-threatening cerebritis as determined by MRI. An average of 2.7 orbital and sinus drainage procedures per patient were required. All three patients reported diplopia, and two required strabismus surgery. Two of three patients developed optic nerve atrophy and visual field loss. All patients had positive cultures, but with these varying organisms: microaerophilic streptococcus; echinobacterium hemolyticum; streptococcus morbillorum and veillonella. Conclusions: This is the first reported series of bilateral orbital cellulitis in children. The constellation of optic nerve atrophy, diplopia and cerebritis resulted despite aggressive multiple orbital and sinus drainage procedures and IV antibiotics.
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