cellulitis

Question 1

what is orbital cellulitis?

Answer 1

Orbital cellulitis is the result of an infection affecting the fat and muscles posterior to the orbital septum, within the orbit but not involving the globe. I

Question 2

causes of orbital cellulitis?

Answer 2

ot is usually caused by a spreading upper respiratory tract infection from the sinuses and carries a high mortality rate.

Question 3

what is periorbital cellulitis?

Answer 3

Periorbital (preseptal) cellulitis is a less serious superficial infection anterior to the orbital septum, resulting from a superficial tissue injury (chalazion, insect bite etc…).

Question 4

risk with periorbital cellulitis?

Answer 4

Periorbital cellulitis can progress to orbital cellulitis.

Question 5

RF?

Answer 5

Childhood
Mean age of hospitalisation 7-12 years
Previous sinus infection
Lack of Haemophilus influenzae type b (Hib) vaccination
Recent eyelid infection/ insect bite on eyelid (periorbital cellulitis)
Ear or facial infection

Question 6

features?

Answer 6

Redness and swelling around the eye
Severe ocular pain
Visual disturbance
Proptosis
Ophthalmoplegia/pain with eye movements
Eyelid oedema and ptosis
Drowsiness +/- Nausea/vomiting in meningeal involvement (Rare)

Question 7

differentiating between orbital and periorbital?

Answer 7

reduced visual acuity, proptosis, ophthalmoplegia/pain with eye movements are NOT consistent with preseptal cellulitis

Question 8

ix?

Answer 8

Full blood count - WBC elevated, raised inflammatory markers.
Clinical examination involving complete ophthalmological assessment - Decreased vision, afferent pupillary defect, proptosis, dysmotility, oedema, erythema.
CT with contrast - Inflammation of the orbital tissues deep to the septum, sinusitis.
Blood culture and microbiological swab to determine the organism. Most common bacterial causes - Streptococcus, Staphylococcus aureus, Haemophilus influenzae B.

Question 9

mx?

Answer 9

admission to hospital for IV antibiotics