Orbital cellulitis Flashcards

1
Q

infection usually spreads via what ?

A

paranasal sinuses, such as ethmoid sinus

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2
Q

what is the infection of?

A

soft tissue posterior to the orbital septum

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3
Q

name 4 causative organisms

A
  • staphylococcus aureus
  • streptococcus pneumoniae
  • H. influenza
  • Betahemolytic streptococcus
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4
Q

causative organism in severely immunocompromised patients?

A

Fungal aspergillus

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5
Q

complications of orbital cellulitis?

A

orbital abscess

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6
Q

what is preseptal/preorbital cellulitis?

A

infection of the anterior portion of the eyelid

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7
Q

what clinical features can distinguish orbital cellulitis from preorbital cellulitis? (6)

A
  • ophthalmoplegia
  • proptosis
  • pain on eye movements
  • visual disturbance
  • chemosis
  • RAPD
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8
Q

Investigations?

A
  • FBC
  • Conjunctival swab
  • CT of orbit w/ contrast
  • Blood cultures + microbial swab
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9
Q

patient’s require hourly monitoring of what? (4)

A
  • HR
  • BP
  • VA
  • Temp
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10
Q

watch closely for changes in what? (5)

A
  • RAPD
  • ocular motility
  • Visual acuity
  • colour vision
  • optic nerve function
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11
Q

how can an orbital abscess be distinguished from an uncomplicated orbital cellulitis?

A

CT w/ contrast of orbit

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12
Q

what is inflamed in preseptal cellulitis?

A

eyelids, skin, subcutaneous tissue of the face, but not the content of the orbit

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13
Q

what is inflamed in orbital cellulitis?

A

extra-ocular muscles

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14
Q

presentation of pre septal cellulitis

A

both eyes swollen + tender

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15
Q

treatment of pre septal cellulitis

A

IV abx

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16
Q

causative pathogens of orbital cellulitis?

A

H. influenzae
Strep
Staph

17
Q

pupillary defect in orbital cellulitis

A

RAPD

due to CN 2 compression

18
Q

management of preseptal cellulitis

A
  1. referral to secondary care for assessment

2. oral abx; usually co-amoxiclav

19
Q

mean age of hospitalisation with orbital cellulitis

A

7-12 years old

20
Q

investigations in orbital cellulitis (4)

A

FBC

CT w/ contrast

Complete ophthalmological assessment

Blood cultures