{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:13:49Z","timestamp":1774941229203,"version":"3.50.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Evaluation of a child with POC\/OC is complicated due difficulties in physical examination and risks of imaging by computed tomography.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>Retrospective review of children 0\u201316 years admitted to the pediatric emergency department for POC\/OC from 2009 to 2019.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Ten years study period, 243 children younger than 16 years presented to the pediatric emergency department with a diagnosis of POC\/OC. OC was documented in 51 (20.6%) patients. The mean age was 7.8 years (\u00b14.3 years). Fever (80.4%), upper respiratory tract infection (43%), swelling of both eyelids (96%), proptosis (33.3%), and tenderness on percussion (24.5%) were more common in comparison to POC (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001, 0.03, 0.0001, 0.0001, 0.0001 respectively). All children with suspected diagnosis of OC underwent computed tomography scan. POC accounted for 196 patients. Mean age was 4.6 (\u00b14.3) years. Twenty percent of the cases were recorded as local trauma or insect bite in the infected eye.<\/jats:p>\n            <jats:p>Mean leukocyte count in the OC group had higher mean of 15.2 (10<jats:sup>9<\/jats:sup>\/L) versus 13.4(10<jats:sup>9<\/jats:sup>\/L) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.05), absolute neutrophil count was significantly higher in the OC 11.3(10<jats:sup>9<\/jats:sup>\/L) versus 7.2(10<jats:sup>9<\/jats:sup>\/L) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001) whereas the lymphocyte count was higher in the POC 4.5(10<jats:sup>9<\/jats:sup>\/L) versus 2.4(10<jats:sup>9<\/jats:sup>\/L) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001), NLR of 0.318 correlates with orbital cellulitis with sensitivity of 75.5% and specificity of 77.4%.<\/jats:p>\n            <jats:p>Patients with OC had mean C-reactive protein levels of 11.7 (mg\/dL) versus 4.9(mg\/dL) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001), erythrocyte sedimentation rate was elevated in the OC 53.6 (cm\/h) versus 36.4 (cm\/h) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02).<\/jats:p>\n            <jats:p>Based on the aforementioned study a risk calculator for OC was formulated with 6 major variables.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Differentiation between POC\/OC is cardinal. This study highlights the importance of ancillary laboratory tests especially C-reactive protein in the assessment of infections of the eye.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002083","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T10:26:43Z","timestamp":1584700003000},"page":"e1473-e1477","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Factors Associated With Increased Risk of Pediatric Orbital Cellulitis\u2014Who Should Be Scanned?"],"prefix":"10.1097","volume":"37","author":[{"given":"Lea","family":"Ohana-Sarna-Cahan","sequence":"first","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noa","family":"Hurvitz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itai","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adi","family":"Cohen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saar","family":"Hashavya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.idc.2007.03.008","article-title":"Periorbital and orbital infections","volume":"21","year":"2007","journal-title":"Infect Dis Clin North Am"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1288\/00005537-197009000-00007","article-title":"The pathogenesis of orbital complications in acute sinusitis","volume":"80","year":"1970","journal-title":"Laryngoscope"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/BF01627937","article-title":"Anatomic study of the orbital septum (22.10.93)","volume":"16","year":"1994","journal-title":"Surg Radiol Anat"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/01.inf.0000227820.36036.f1","article-title":"Orbital cellulitis in children","volume":"25","year":"2006","journal-title":"Pediatr Infect Dis J"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1542\/pir.31.6.242","article-title":"Periorbital and Orbital Cellulitis","volume":"31","year":"2010","journal-title":"Pediatr Rev"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"131","DOI":"10.2310\/7070.2002.10979","article-title":"Orbital complications of sinusitis in children","volume":"31","year":"2002","journal-title":"J Otolaryngol"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"175","DOI":"10.4103\/jovr.jovr_199_17","article-title":"Common orbital infections ~ state of the art ~ part I","volume":"13","year":"2018","journal-title":"J Ophthalmic Vis Res"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.emc.2007.11.001","article-title":"Pediatric ophthalmology in the emergency department","volume":"26","year":"2008","journal-title":"Emerg Med Clin North Am"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"e719","DOI":"10.1542\/peds.2009-1709","article-title":"Acute periorbital infections: who needs emergent imaging?","volume":"125","year":"2010","journal-title":"Pediatrics"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0140-6736(12)60815-0","article-title":"Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study","volume":"380","year":"2012","journal-title":"Lancet"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00004397-200110000-00009","article-title":"Orbital cellulitis in children","volume":"41","year":"2001","journal-title":"Int Ophthalmol Clin"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1288\/00005537-198605000-00018","article-title":"Clinical implications of orbital cellulitis","volume":"96","year":"1986","journal-title":"Laryngoscope"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1097\/00006454-200110000-00017","article-title":"Medical management of orbital cellulitis","volume":"20","year":"2001","journal-title":"Pediatr Infect Dis J"},{"key":"bib14-20250504","first-page":"472","article-title":"Use of biomarkers in pediatric sepsis: literature review","volume":"28","year":"2016","journal-title":"Rev Bras Ter Intensiva"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jpeds.2008.04.023","article-title":"Systematic review of the diagnostic accuracy of C-reactive protein to detect bacterial infection in nonhospitalized infants and children with fever","volume":"153","year":"2008","journal-title":"J Pediatr"},{"key":"bib16-20250504","first-page":"2197","article-title":"C-reactive protein ratio response patterns in pediatric sepsis : a cohort study\u2014preliminary results","volume":"3","year":"2015","journal-title":"Intensive Care Med Exp"},{"key":"bib17-20250504","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/IOP.0000000000000349","article-title":"C-reactive protein as a marker for initiating steroid treatment in children with orbital cellulitis","volume":"31","year":"2015","journal-title":"Ophthal Plast Reconstr Surg"},{"issue":"suppl 1","key":"bib18-20250504","first-page":"17","article-title":"C-reactive protein concentrations during initial (empiric) treatment of neonatal sepsis","volume":"129","year":"2001","journal-title":"Srp Arh Celok Lek"},{"key":"bib19-20250504","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s15010-007-7077-9","article-title":"The time course of blood C-reactive protein concentrations in relation to the response to initial antimicrobial therapy in patients with sepsis","volume":"36","year":"2008","journal-title":"Infection"},{"key":"bib20-20250504","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jcrc.2017.11.018","article-title":"Patterns of C-reactive protein ratio response to antibiotics in pediatric sepsis: a prospective cohort study","volume":"44","year":"2018","journal-title":"J Crit Care"},{"key":"bib21-20250504","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1080\/01676830.2016.1176205","article-title":"Periorbital cellulitis in children : analysis of outcome of intravenous antibiotic therapy","volume":"35","year":"2016","journal-title":"Orbit"},{"key":"bib22-20250504","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijporl.2019.02.003","article-title":"Pediatric preseptal and orbital cellulitis: a 10-year experience","volume":"120","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"bib23-20250504","doi-asserted-by":"crossref","first-page":"e46561","DOI":"10.1371\/journal.pone.0046561","article-title":"The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia","volume":"7","year":"2012","journal-title":"PLoS One"},{"key":"bib24-20250504","doi-asserted-by":"crossref","first-page":"e87315","DOI":"10.1371\/journal.pone.0087315","article-title":"Biomarkers and molecular analysis to improve bloodstream infection diagnostics in an emergency care unit","volume":"9","year":"2014","journal-title":"PLoS One"},{"key":"bib25-20250504","doi-asserted-by":"crossref","first-page":"e229","DOI":"10.1097\/MPH.0000000000001059","article-title":"The value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for detecting early-onset neonatal Sepsis","volume":"40","year":"2018","journal-title":"J Pediatr Hematol Oncol"},{"key":"bib26-20250504","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ijporl.2007.11.013","article-title":"Paediatric pre- and post-septal peri-orbital infections are different diseases A retrospective review of 262 cases","volume":"72","year":"2008","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"bib27-20250504","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/MOO.0b013e32834cd54a","article-title":"Management of pediatric orbital cellulitis and abscess","volume":"19","year":"2011","journal-title":"Curr Opin Otolaryngol Head Neck Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:03:31Z","timestamp":1746389011000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":27,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002083","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3,20]]}}}