Retrospective study finds MRSA in nearly half of eyebrow infections

This study reviews the bacterial origins and potential causative factors of preseptal cellulitis and abscesses involving the eyebrow.

Study design

Researchers retrospectively reviewed the demographic data, clinical history and bacteriology culture results from 80 patients who were treated for an eyebrow abscess or preseptal cellulitis at the Massachusetts Eye and Ear Infirmary over a 7-year period (2008-2015).

Outcomes

An eyebrow abscess was present in 54 cases (67.5%), while 26 cases (32.5%) had preseptal cellulitis without an abscess. The most common pathogen, methicillin-resistant staphylococcus aureus (MRSA), was found in nearly 40% of cultures, whereas methicillin-sensitive S. aureus (MSSA) was found in about 24% of cultures, and coagulase-negative staph was found in 14% of cultures.  About a third of the infections were preceded by eyebrow hair removal or manipulation of acne.

Limitations

The study is retrospective, limiting the amount of data available for analysis. Furthermore, the findings may not be representative of most eyebrow infections because this tertiary academic referral center may predominantly treat severe infections.

Clinical significance

The findings suggest that clinicians should consider empiric antibiotic coverage for MRSA in patients who present with an eyebrow abscess or preseptal cellulitis. Clinicians should also question these patients about eyebrow hair removal or manipulation of acne lesions, which may be risk factors for infection.