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Study: Hib vaccine changes epidemiology of periorbital cellulitis in children
J Pediatr Ophthalmol Strabismus. 2008;45(5):300-304.
Haemophilus influenzae type B infection is not a common cause of periorbital cellulitis, particularly not since the introduction of Hib vaccine more than 2 decades ago.
According to a prospective study of 180 children with clinical findings of periorbital inflammation who were hospitalized in Israel between 2001 and 2002, 163 patients (mean age 34 months) had final discharge diagnosis of periorbital cellulitis. Attributable predisposing medical conditions were conjunctivitis (70 cases), infected wound or trauma, insect bite, sinusitis, dacryostenosis and one case of Streptococcus pneumoniae bacteremia. No cases of Hib infection were found, and 71% of the 163 children had received complete Hib immunization before being hospitalized. No predisposing factor was identified in 13% of cases.
The researchers said the role of better treatment of conjunctivitis — the predisposing condition in 40% of cases in their series — should be further studied as a means of preventing periorbital cellulitis in children.
Conjunctival cultures yielded S. pneumoniae, Streptococcus aureus, nontypable H. influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Staphylococcus epidermidis and Streptococcus viridians.