Periorbital Cellulitis Flashcards
What are the 2 types?
Pre septal
Post septal
Is pre or post septal cellulitis more severe?
Post septal - infection can spread intracranially
What can cause periorbital cellulitis?
Infection from bites, periorbital trauma, sinus spread (frontal and ethmoid)
What complications can occur?
Abscess formation
Spread of infection intracranially
Where do the veins of the orbit drain to?
Cavernous sinus
Pterygoid venous plexus
Facial veins
How does orbital cellulitis present?
Redness and swelling around eye Severe ocular pain Visual disturbance Proptosis Opthalmoplegia/ pain with eye movements Eyelid oedema and ptosis Drowsiness +/- nausea or vomiting in meningeal involvement (rare)
Is post septal cellulitis an emergency?
Yes required hospital admission and urgent senior review
How would you differentiate pre and post orbital cellulitis?
Reduced visual acuity, proptosis, opthalmoplegia/pain with eye movements are not consistent with pre septal cellulitis
What investigations are needed?
FBC - raised inflammatory markers Clinical examination CT with contrast - inflammation of orbital tissue, sinusitis Blood culture Swab
How should post septal cellulitis be managed?
Admission to hospital for IV antibiotics
Preseptal cellulitis usually occurs in what age group?
Children 80% are under 10
When does infection usually spread from?
Breaks in the skin
Local infections such as sinusitis or other respiratory tract infections
Most frequent causative organisms = staph aureus, staph epidermidis, streptococci and anaerobic bacteria
