Clinical Characteristics and Differences in Pathogen Distribution of Orbital Cellulitis Between Children and Adults in Northern China
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Background: To investigate the differences in clinical features and pathogen distribution of orbital cellulitis between adults and children in northern China, and to provide evidence for precise clinical diagnosis and management. Methods: A retrospective analysis was conducted on the clinical data of 131 patients with orbital cellulitis admitted to Hebei Eye Hospital between 2014 and 2023, including 76 adults and 55 children. The two groups were compared in terms of etiologies, treatment modalities, length of hospital stay, and microbiological results. Results: No significant differences were observed between groups in sex, geographical distribution, or seasonal variation. However, adults showed significantly higher rates of surgical intervention (44.7% vs. 25.5%, P < 0.05) and a longer median hospital stay (11 days vs. 7 days, P < 0.001) compared with children. Regarding etiologies, pediatric cases were predominantly attributed to rhinogenic infections (58.2%), whereas adult cases showed more heterogeneous causes, including trauma (21.3%) and lacrimal apparatus diseases (18.7%). Microbiological analyses revealed that all pathogens isolated from children were Gram-positive bacteria (100%), whereas adults exhibited a more diverse pathogen spectrum, including Gram-positive bacteria (69.6%), Gram-negative bacteria (28.3%), and fungi (2.2%). The overall microbial composition differed significantly between the two groups (P < 0.05). Conclusions: Adults and children with orbital cellulitis differ substantially in etiologies, pathogen profiles, and clinical manifestations. Age-specific individualized management is therefore essential: pediatric patients should be treated with emphasis on rhinogenic sources and adequate coverage of Gram-positive bacteria, while adult patients require consideration of more diverse etiologies and may benefit from broader-spectrum empirical antimicrobial regimens to optimize clinical outcomes.
