89 A Retrospective Study on the Emergency Department Outpatient Management of Pediatric Periorbital Cellulitis
Notice bibliographique
Résumé
Periorbital cellulitis is an infection of the preseptal soft tissues that is often seen in a pediatric emergency department. Potential risks include progression to an orbital cellulitis and its complications. Prior to the introduction of the Hib vaccine in the mid 1980's, peri-orbital cellulitis was treated on an inpatient basis. Post Hib vaccine periorbital cellulitis is often treated as an outpatient, using broad-spectrum IV antibiotics. Emergency Department outpatient management is a safe method of treatment for children with periorbital cellulitis. A retrospective chart review was conducted on all cases with a discharge diagnosis of periorbital cellulitis extracted from visits to the Pediatric Emergency Department at Children's Hospital of Western Ontario from July 2000 to December 2002. Data collected included diagnostic criteria, physical findings, treatment type and duration, outcome and adverse outcomes. Stringent diagnostic criteria (SDC) of edema, erythema and fever (>38°C) were set as our diagnostic criteria of perior-bital cellulites although we reviewed all cases. Clinical treatment failure (CTF) was defined as a need to change route (PO to IV) and/or antibiotic choice or hospitalization. 87 cases of periorbital cellulitis were identified and reviewed. Of the 87 cases examined, 6 patients were admitted immediately and hence excluded. 16 (19.7%) cases met SDC, 65 cases did not. Fever was the absent symptom in over 90% of the cases that did not meet the SDC. Physical findings that would aid in the differential diagnosis of periorbital verses orbital cellulitis were not recorded in 24 to 68% of all patients. Blood and surface cultures were rarely positive or aided in therapy. Diagnostic imaging was rarely used, and only used in cases not responding to therapy. In the SDC, 6 were treated with oral antibiotics and 10 with IV antibiotics with no clinical failures with either treatment. In the non-stringent diagnostic group, 32 were treated with oral antibiotics and 33 with IV antibiotics. This group had 7 (10.8%) CTF with 2 on oral and 5 on IV. The average duration on IV antibiotics was 2.2 days and 8.3 days for oral antibiotics. The most common antibiotic prescribed for oral treatment was Keflex, whilst Cefuroxime was the most often used IV antibiotic therapy. The SDC for periorbital cellulitis are not universally applied. Indicators differentiating periorbital cellulitis from orbital cellulitis are not often documented. The outpatient management of periorbital cellulitis, with close follow-up, appears to be a safe practice with less than an 11% CTF rate.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».