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Ophthalmology. 2000 Aug;107(8):1450-3.

Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination.

Author information

1
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. bambati@yahoo.com

Abstract

OBJECTIVE:

To evaluate the effect of the introduction of the Haemophilus influenzae B (Hib) vaccine (introduced first in 1985, then extended in 1990 to children at least 2 months of age) on the epidemiologic features of periorbital and orbital cellulitis.

DESIGN:

Retrospective, comparative case series.

PARTICIPANTS:

Three hundred fifteen pediatric inpatients.

METHODS:

Children at Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary with discharge diagnosis of periorbital or orbital cellulitis from 1980 through 1998 were reviewed.

MAIN OUTCOME MEASURES:

Case rate, culture-positive isolates, and associated conditions.

RESULTS:

A total of 297 cases of periorbital cellulitis and 18 cases of orbital cellulitis were reviewed. Before 1990, there were 27 cases of Hib-related cellulitis (11.7% of total in that period), whereas after 1990, there were only three (3.5% of total; P = 0.028). The number of cases per year was significantly lower after 1990 (21.2 +/- 10.4 vs. 8.7 +/- 3.9; P = 0.008), as were the number of positive culture isolates (for any organism) after 1990 (76 [33. 0%] vs. 9 [10.6%]; P < 0.001). The medical conditions most commonly associated with periorbital cellulitis were sinusitis (44 [14.5%]) and upper respiratory infections (73 [26.6%]). All cases of orbital cellulitis were associated with sinusitis.

CONCLUSIONS:

The introduction of the Hib vaccine coincided with a sharp decline not only in the number of periorbital and orbital cellulitis cases related to H. influenzae, but also in the annual case rate. These data are consistent with a facilitative role for H. influenzae in the development of cellulitis secondary to other pathogens. They also may support restriction of the spectrum of antibiotics used to manage these conditions.

PMID:
10919886
DOI:
10.1016/s0161-6420(00)00178-0
[Indexed for MEDLINE]

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