Orbital cellulitis Flashcards
infection usually spreads via what ?
paranasal sinuses, such as ethmoid sinus
what is the infection of?
soft tissue posterior to the orbital septum
name 4 causative organisms
- staphylococcus aureus
- streptococcus pneumoniae
- H. influenza
- Betahemolytic streptococcus
causative organism in severely immunocompromised patients?
Fungal aspergillus
complications of orbital cellulitis?
orbital abscess
what is preseptal/preorbital cellulitis?
infection of the anterior portion of the eyelid
what clinical features can distinguish orbital cellulitis from preorbital cellulitis? (6)
- ophthalmoplegia
- proptosis
- pain on eye movements
- visual disturbance
- chemosis
- RAPD
Investigations?
- FBC
- Conjunctival swab
- CT of orbit w/ contrast
- Blood cultures + microbial swab
patient’s require hourly monitoring of what? (4)
- HR
- BP
- VA
- Temp
watch closely for changes in what? (5)
- RAPD
- ocular motility
- Visual acuity
- colour vision
- optic nerve function
how can an orbital abscess be distinguished from an uncomplicated orbital cellulitis?
CT w/ contrast of orbit
what is inflamed in preseptal cellulitis?
eyelids, skin, subcutaneous tissue of the face, but not the content of the orbit
what is inflamed in orbital cellulitis?
extra-ocular muscles
presentation of pre septal cellulitis
both eyes swollen + tender
treatment of pre septal cellulitis
IV abx
causative pathogens of orbital cellulitis?
H. influenzae
Strep
Staph
pupillary defect in orbital cellulitis
RAPD
due to CN 2 compression
management of preseptal cellulitis
- referral to secondary care for assessment
2. oral abx; usually co-amoxiclav
mean age of hospitalisation with orbital cellulitis
7-12 years old
investigations in orbital cellulitis (4)
FBC
CT w/ contrast
Complete ophthalmological assessment
Blood cultures
