Abstract
Purpose :
C-Reactive Protein (CRP) levels have been shown to have prognostic value in pediatric bacterial infections, including orbital cellulitis. However, it is unclear how frequently CRP levels are utilized for diagnostic evaluation and management. The purpose of this study is to determine how frequently CRP levels were obtained and to evaluate for any correlation of CRP levels with presenting signs and symptoms, radiographic findings, or prognosis.
Methods :
We performed a retrospective chart review of all cases of orbital cellulitis in patients age 1 – 18 years old in a large, tertiary-care academic institution from January 2008 to January 2018 to measure the frequency CRP levels were obtained. We explored the relationship between CRP levels and signs and symptoms at presentation, clinical prognosis (length of stay), and demographic data. Lastly, we examined how the CRP level changed throughout admission. Information recorded included laterality, association with sinusitis, sex, race, age, time of year during presentation, treatment course, laboratory values throughout the hospital course, and major complications including abscess, operations, etc. Patients were excluded if the final diagnosis was not orbital cellulitis or if insufficient data was available in the patient chart. SPSS statistical analysis software was used to perform statistical testing. Categorical variables were compared with chi squared tests (Fisher’s exact tests). Categorical data were compared with continuous data with independent samples t-tests.
Results :
54 patients were included in the study, 15 who had a CRP level measured during admission and 39 who did not. CRP was elevated in 9/15 (60%) of patients at the time of diagnosis. CRP elevation at the time of diagnosis was not found to correlate with sex (p=0.136), race (p=0.732), length of stay (p=0.494), whether steroids were administered during admission (p=0.791), whether sinus symptoms were present at admission (p=0.815), or whether an abscess was present on imaging (p=0.906). There was insufficient data to determine trends in CRP levels as treatment course progressed.
Conclusions :
CRP level was not routinely ordered in our pediatric population presenting with orbital cellulitis and was not often used prognostically. Our study had significant data limitations, mostly driven by the small sample size. Further studies should evaluate the diagnostic and prognostic utility of CRP in pediatric orbital cellulitis.
This is a 2021 ARVO Annual Meeting abstract.