[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
July 1988

Subperiosteal Inflammation of the OrbitA Bacteriological Analysis of 17 Cases

Author Affiliations

From the Section of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.

Arch Ophthalmol. 1988;106(7):947-952. doi:10.1001/archopht.1988.01060140093032

• Seventeen cases of subperiosteal inflammation of the orbit secondary to sinusitis were analyzed from a bacteriological perspective. The recovered pathogens ranged from single aerobes to mixed aerobes and anaerobes. The bacteriology was not related to the duration of symptoms of sinusitis. Three cases with the diagnostic criteria for subperiosteal inflammation resolved with antibiotics alone. The most refractory infections had the most complex bacterial constituencies and persisted despite in vitro antibiotic susceptibility of individual organisms. In these cases, local physical conditions may be drastically altered in favor of the bacteria. Ventilation of the subperiosteal space and sinuses by surgical drainage can help to normalize the milieu in favor of the host.

Harris GJ:  Subperiosteal abscess of the orbit . Arch Ophthalmol 1983;101:751-757.Article
Lemke BN, Gonnering RS, Harris GJ, et al:  Orbital cellulitis with periosteal elevation . Ophthalmic Plast Reconstr Surg 1987;3:1-7.Article
Gold SC, Arrigg PG, Hedges TR III:  Computerized tomography in the management of acute orbital cellulitis . Ophthalmic Surg 1987;18:753-756.
Towbin R, Han BK, Kaufman RA, et al:  Postseptal cellulitis: CT in diagnosis and management . Radiology 1986;158:735-737.Article
Bauer AW, Kirby WMM, Sherris JC, et al:  Antibiotic susceptibility testing by a standardized single disk method . Am J Clin Pathol 1966;45:493-496.
Thornsberry C, Gavan TL, Gerlach EH: Cumitech 6: New Developments in Antimicrobial Agent Susceptibility Testing . Washington, DC, American Society for Microbiology, 1977.
Allen SD:  Gram-positive, nonsporeforming anaerobic bacilli , in Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 4. Washington, DC, American Society for Microbiology, 1985, p 470.
Evans FO, Sydnor JB, Moore WEC, et al:  Sinusitis of the maxillary antrum . N Engl J Med 1975;293:735-739.Article
Gwaltney JM Jr, Sydnor A Jr, Sande MA:  Etiology and antimicrobial treatment of acute sinusitis . Otol Rhinol Laryngol 1981;90:68-71.
Wald ER, Milmoe GJ, Bowen A'D, et al:  Acute maxillary sinusitis in children . N Engl J Med 1981;304:749-754.Article
Gwaltney JM:  Acute sinusitis in adults . Am J Otolaryngol 1983;4:422-423.Article
Wald ER:  Acute sinusitis and orbital complications in children . Am J Otolaryngol 1983;4:424-427.Article
Kallings LO:  Bacteriological aspects of infections of the upper respiratory tract . Scand J Infect Dis Suppl 1983;39:9-13.
Wald ER, Reilly JS, Casselbrant M, et al:  Treatment of acute maxillary sinusitis in childhood: A comparative study of amoxicillin and cefaclor . J Pediatr 1984;104:297-302.Article
Frederick J, Braude AI:  Anaerobic infection of the paranasal sinuses . N Engl J Med 1974;290:135-137.Article
Karma P, Jokipii L, Sipila P, et al:  Bacteria in chronic maxillary sinusitis . Arch Otolaryngol Head Neck Surg 1979;105:386-390.Article
Su WY, Liu C, Hung SY, et al:  Bacteriological study in chronic maxillary sinusitis . Laryngoscope 1983;93:931-934.Article
Gorbach SL, Bartlett JG:  Anaerobic infections (third of three parts) . N Engl J Med 1974;290:1289-1294.Article
Bartlett JG:  Recent developments in the management of anaerobic infections . Rev Infect Dis 1983;5:235-245.Article
Brook I:  Bacteriologic features of chronic sinusitis in children . JAMA 1981;246:967-969.Article
Carenfelt C, Lundberg C, Nord CE, et al:  Bacteriology of maxillary sinusitis in relation to quality of the retained secretion . Acta Otolaryngol 1978;86:298-302.Article
Brooks GF, O'Donoghue JM, Rissing JP, et al:  Eikenella corrodens: A recently recognized pathogen: infections in medical-surgical patients and in association with methylphenidate abuse . Medicine 1974;53:325-342.Article
Brook I:  Aerobic and anaerobic bacterial flora of normal maxillary sinuses . Laryngoscope 1981;91:372-376.
Shapiro ED, Wald ER, Doyle W, et al:  Bacteriology of the maxillary sinus of rhesus monkeys . Ann Otol 1982;91:150-151.
Lundberg C, Engquist S:  Pathogenesis of maxillary sinusitis . Scand J Infect Dis Suppl 1983;39:53-55.
Carenfelt C, Lundberg C:  Purulent and non-purulent maxillary sinus secretions with respect to Po2, Pco2 and pH . Acta Otolaryngol 1977;84:138-144.Article
Carenfelt C, Lundberg C:  The role of local gas composition in pathogenesis of maxillary sinus empyema . Acta Otolaryngol 1978;85:116-121.Article
Haynes RE, Cramblett HG:  Acute ethmoiditis: Its relationship to orbital cellulitis . AJDC 1967;114:261-267.
English GM:  Sinusitis , in English GM (ed): Otolaryngology . New York, Harper & Row Publishers Inc, 1980, vol 2, chap 21.
Tramont EC:  General or nonspecific host defense mechanisms , in Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases , ed 2. New York, John Wiley & Sons Inc, 1985, pp 25-31.
Gorbach SL:  (Anaerobic bacteria) General concepts , in Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases , ed 2. New York, John Wiley & Sons Inc, 1985, pp 1349-1355.
Ekedahl C:  Treatment of maxillary sinusitis . Scand J Infect Dis Suppl 1983;39:56-58.
Ingham HR, Sisson PR, Middleton RL, et al:  Phagocytosis and killing of bacteria in aerobic and anaerobic conditions . J Med Microbiol 1981;14:391-399.Article
Gorbach SL:  Bacteroides species , in Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases , ed 2. New York, John Wiley & Sons Inc, 1985, pp 1368-1373.
Hackman AS, Wilkins TD:  Influence of penicillinase production by strains of Bacteroides melaninogenicus and Bacteroides oralis on penicillin therapy of an experimental mixed anaerobic infection in mice . Arch Oral Biol 1976;21:385-389.Article
Roberts RB:  Viridans and beta hemolytic (nongroup A, B, and D) streptococci , in Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases , ed 2. New York, John Wiley & Sons Inc, 1985, pp 1162-1171.
Murray HW, Gross KC, Masur H, et al:  Serious infections caused by Streptococcus milleri . Am J Med 1978;64:759-764.Article
Arala-Chaves MP, Higerd TB, Porto MT, et al:  Evidence for the synthesis and release of strongly immunosuppressive, non-cytotoxic substances by Streptococcus intermedius . J Clin Invest 1979;64:871-883.Article