pre-septal and orbital cellulitis

Question 1

what is pre-septal cellulitis?

Answer 1

Pre-septal cellulitis is a common skin infection that affects tissues anterior to the
septum. The orbital septum is a structure that divides the tissue space into anterior
septal (pre-septal) and posterior septal (orbital) from the edge of the tarsal plate that
extends to the orbital rim.

Question 2

hx for pre-septal cellultis?

Answer 2

Pre-septal cellulitis is a common presentation in the paediatric and adult setting.
There may be a history of skin trauma, insect bite or localised periocular infection.
The most common organism responsible is Staphylococcus aureus.

Question 3

sx of pre-septal cellulitis?

Answer 3

Patients present

with erythematous and swollen periocular skin, and some may have a fever.

Question 4

mx of pre-septal cellulitis

Answer 4

Most
cases of pre-septal cellulitis can be treated with oral antibiotics, though care must be
taken to differentiate this from orbital cellulitis.

Question 5

what is orbital cellulitis

?

Answer 5

Orbital cellulitis is a sight and life-threatening conditions which must be treated with
caution. The most common organisms responsible for this includes Haemophilus
influenza, Streptococcus pneumoniae and Staphylococcus aureus

Question 6

sx of orbital cellulitis?

Answer 6

There may be a
history of coryzal symptoms, sinusitis, dental abscess or pre-septal cellulitis. Patients
can present acutely unwell with a fever, malaise, pain, swollen eyelids, proptosis and
restriction in eye movements. There may be a compromise to optic nerve function
with reduced vision, reduced colour vision, and a relative afferent pupillary defect.
Compromise to optic nerve function is often the deciding factor in surgical
intervention for drainage of orbital abscess, therefore visual function must be
monitored regularly during the admission.

Question 7

complications of orbital cellulitis?

Answer 7

Potential life-threatening complication of orbital cellulitis include intracranial
extension of the abscess, sepsis and cavernous sinus thrombosis.

Question 8

Ix and Mx for orbital cellulitis?

Answer 8

Investigations
should include serum tests for FBC, inflammatory markers and blood cultures.
Formal imaging should be sought ideally in the form of a CT orbit, sinuses and brain.
The patient should be admitted and treated with intravenous antibiotics, resuscitated
appropriately and under the care of a multidisciplinary team including
Ophthalmology, ENT and Neurosurgery depending on the extent of the involvement.
In paediatric cases, the patient should be admitted under the care of the paediatric
team.