鼻窦炎继发眼眶蜂窝织炎病原菌的医院研究及临床表现

Gihan Shokier, Sara Rabiea, M. Soliman, A. E. El Batawi, R. Ahmed, Nermeen Bahgat
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摘要

目的本研究的目的是评估继发于鼻窦炎的眼眶蜂窝组织炎的行为,以及在开罗大学医院就诊的患者中病原体的检测。患者和方法这是一项队列研究,43例被诊断为鼻窦炎继发性眼眶蜂窝组织炎的患者入院并纳入研究。所有患者都接受了彻底的眼科检查、耳鼻喉科会诊和系统评估。对所有患者进行了眼眶、鼻窦和大脑的冠状和轴向计算机断层扫描。一些患者从鼻窦或眼睑脓肿排出的脓液中取出标本进行培养和敏感性检测。结果本研究共涉及43例。平均年龄23.93±19.38岁。7名患者有系统性医疗障碍。6名患者患有糖尿病。所有患者均接受了抗菌治疗,其中7名(16.2%)患者需要添加抗真菌治疗,7名(162%)患者需添加类固醇。共有20名(46.5%)患者需要手术干预。在这些被送去进行培养和敏感性检测的患者中,5人(11.6%)患有细菌感染,7人(16.3%)患有真菌感染,8人(18.6%)没有生长。共有39名(90.7%)患者对治疗有临床反应,4名患者在6个月内复发。结论细菌感染是鼻窦炎继发眼眶蜂窝组织炎最常见的病因。糖尿病是真菌感染的易感因素,预后不良,视力达不到光感。
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Hospital-based study of causative organisms and clinical picture of orbital cellulitis secondary to sinusitis
Objectives The aim of this study was to assess the behavior of orbital cellulitis secondary to sinusitis and the detection of the causative organisms in patients presenting to Cairo University Hospitals. Patients and methods This was a cohort study in which 43 cases diagnosed with orbital cellulitis secondary to sinusitis were admitted to hospital and were enrolled in the study. All patients underwent thorough ophthalmological examinations, ENT consultations, and systemic assessments. Coronal and axial computed tomography scans of orbit, paranasal sinuses, and brain were done for all patients. Some patients had specimen sent for culture and sensitivity from the drained pus either from sinuses or lid abscesses. Results A total of 43 cases were involved in this study. The mean age was 23.93±19.38 years. Seven patients had systemic medical disorders. Six patients were diabetic. All patients received antimicrobial treatment, with seven (16.2%) patients needing addition of antifungal treatment and seven (16.2%) patients needing addition of steroids. A total of 20 (46.5%) patients needed surgical intervention. From these patients who had a specimen sent for culture and sensitivity, five (11.6%) had bacterial infections, seven (16.3%) had fungal infections, and eight (18.6%) showed no growth. A total of 39 (90.7%) patients responded clinically to treatment and four patients had recurrence within 6 months. Conclusion Bacterial infection was the commonest cause of orbital cellulitis secondary to sinusitis in the current study. Diabetes mellitus was a predisposing factor to fungal infection, which had a poor prognosis, in which visual acuity reached no light perception.
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