Cellulite orbitaria

Question 1

general

Answer 1

• An infection of the orbital contents, such as the fat and extraocular muscles
• Posterior to the orbital septum
• The eye globe is not affected.

Question 2

Eziologia

Answer 2

-Complication of upper respiratory tract infection, most commonly due to bacterial rhinosinusitis

Other causes include:

• Acute dacryocystitis
• Infection of the teeth, middle ear (see acute otitis media), or face
• Infected mucocele
• Orbital trauma (see emergency ophthalmology)
• Ophthalmic surgery

Question 3

diagnosi

Answer 3

• Primarily a clinical diagnosis
• Laboratory tests: leukocytosis; positive blood and tissue fluid cultures
• CT scan: confirm diagnosis and look for complications, e.g., orbital abscess or intracranial extension

Question 4

Trattamento

Answer 4

🧨Empiric IV antibiotic treatment includes vancomycin PLUS one of the following: ceftriaxone, cefotaxime, ampicillin-sulbactam, piperacillin-tazobactam, or, if the patient is allergic to penicillins and cephalosporins, either ciprofloxacin or levofloxacin to cover S. aureus for 1–2 weeks

🧨If intracranial extension is suspected, metronidazole should be added to ceftriaxone or cefotaxime to cover anaerobes

🧨Surgical drainage is indicated in abscess formation
For treatment of mucormycosis, see mucormycosis

Question 5

Complicanze

Answer 5

• Subperiosteal or orbital abscess
• Blindness due to involvement of the optic nerve
• Brain abscess

Other rare complications: cavernous sinus thrombosis and central retinal artery occlusion