Sub-Periosteal Abscess
A pediatric patient presented as a transfer from OSH with orbital cellulitis secondary to a superior located sub-periosteal abscess (SPA). The patient has a history of acute on chronic sinusitis and had FESS with sinus debridement and abscess drainage 5 days prior to arrival. Post-operatively, he was on IV antibiotics, yet the SPA still recurred. He had several indications for SPA drainage including age (<9 yo), non medial SPA location, and recurrence after prior drainage. Thus, he underwent a lid crease incision orbitotomy with drainage and penrose drain placement. He was placed on PO steroids 1mg/kg and kept on IV antibiotics for 24 hours before transitioning to PO. Close examination is needed to determine the need for surgery vs observation. A course of steroids should be considered in all pediatric subperiosteal abscesses.
Presentation Date: 04/06/2023
Issue Date: 04/14/2023
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