This study examined the relationship between acute rhinosinusitis (ARS) and the severity of periorbital cellulitis in children.

A retrospective case-control study involved 118 pediatric patients diagnosed with periorbital cellulitis, grouped as cases or controls based on ARS presence. ARS was characterized by clinical symptoms alongside the objective confirmation of the disease through computed tomography scan findings. Collected data included patients' characteristics, treatment, hospitalization duration, and follow-up visits.

Those with ARS exhibited a younger age compared to those without ARS (6.3 vs. 8.5, p = 0.025). Nevertheless, no significant differences in gender were observed between the two groups (p = 0.540). The ARS cohort exhibited a higher prevalence of postseptal cellulitis (51.5% vs. 9.6%, p < 0.001). In comparison to patients without ARS, those with ARS had an increased likelihood of hospitalization (p < 0.001), longer hospital stays (median of 3.5 days vs. 0.5 days, p < 0.001), need for intravenous antibiotics (95.3% vs. 54.9%, p < 0.001), and requirement for surgical intervention (23.1% vs. 5.8%, p < 0.001). However, the rate of readmission was similar between both groups.

Pediatric patients with acute periorbital cellulitis and concurrent ARS often experience more severe infections that necessitate elevated levels of care. It is essential to evaluate and integrate ARS into the treatment strategy for pediatric patients with periorbital infections.