Preseptal and Periorbital Cellulitis Flashcards
What is Preseptal (Periorbital) Cellulitis?
An infection of the anterior portion of the eyelid that does not involve the orbit or globe.
What are the most common pathogens associated with Preseptal Cellulitis?
Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae.
What are the risk factors for Preseptal Cellulitis?
Sinusitis, contagious skin infections (e.g., bug bites, trauma), and recent upper respiratory infections.
What are the clinical features of Preseptal Cellulitis?
Eyelid erythema, edema, tenderness, possible fever, but NO proptosis or ophthalmoplegia.
How is Preseptal Cellulitis diagnosed?
Clinical diagnosis; imaging (CT scan of orbit and sinuses) is done if orbital involvement is suspected.
How is Preseptal Cellulitis treated?
Oral antibiotics: clindamycin or TMP-SMX (Bactrim), possibly combined with amoxicillin or cephalexin.
What is Orbital Cellulitis?
An infection involving the orbital tissues, including fat and ocular muscles, but not the globe itself.
What are the most common pathogens associated with Orbital Cellulitis?
Staphylococcus aureus (including MRSA), Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae (in unvaccinated individuals).
What are the risk factors for Orbital Cellulitis?
Sinusitis (especially ethmoid sinusitis), orbital trauma, eye surgery, dental infections, bacteremia.
What are the clinical features of Orbital Cellulitis?
Eyelid erythema, edema, pain, fever, proptosis, ophthalmoplegia (painful eye movements), and possibly vision impairment.
What are the key complications of Orbital Cellulitis?
Subperiosteal/orbital abscess, cavernous sinus thrombosis, meningitis, brain abscess, blindness.
How is Orbital Cellulitis diagnosed?
CT scan of orbit and sinuses to evaluate for orbital involvement and complications.
How is Orbital Cellulitis treated?
IV antibiotics: vancomycin + ceftriaxone (or ampicillin-sulbactam). Surgery if abscess or worsening symptoms.
How to differentiate Preseptal from Orbital Cellulitis?
Orbital cellulitis has proptosis, ophthalmoplegia, and vision impairment, whereas preseptal does not.
What is the role of surgery in Orbital Cellulitis?
Surgical drainage is needed if there is an abscess, worsening symptoms, or failure to improve on IV antibiotics.
What is the role of vaccination in preventing Orbital Cellulitis?
Hib vaccination has greatly reduced cases of Haemophilus influenzae-related orbital cellulitis.
