Preseptal cellulitis Flashcards
What is preseptal cellulitis also known as?
Periorbital cellulitis
What does preseptal cellulitis infect?
Soft tissues anterior to the orbital septum, including eyelids, skin, and subcutaneous tissue of the face
How does preseptal cellulitis differ from orbital cellulitis?
Preseptal cellulitis is anterior to the orbital septum, while orbital cellulitis is behind the orbital septum and is more serious
What are common sources of infection for preseptal cellulitis?
Breaks in the skin or local infections such as sinusitis or respiratory tract infections
What are the most frequently causative organisms of preseptal cellulitis?
- Staph. aureus
- Staph. epidermidis
- Streptococci
- Anaerobic bacteria
In which age group does preseptal cellulitis most commonly occur?
Children, with 80% of patients under 10 years old
What is the median age of presentation for preseptal cellulitis?
21 months
When does preseptal cellulitis occur more frequently?
In the winter due to increased respiratory tract infections
What are the common symptoms of preseptal cellulitis?
Red, swollen, painful eye of acute onset, possibly with fever
What signs are present in preseptal cellulitis?
- Erythema and oedema of the eyelids
- Partial or complete ptosis
- Absence of orbital signs
What orbital signs must be absent in preseptal cellulitis?
- Pain on movement of the eye
- Restriction of eye movements
- Proptosis
- Visual disturbance
- Chemosis
- RAPD
What are significant differential diagnoses for preseptal cellulitis?
- Orbital cellulitis
- Allergic reaction
What investigations are recommended for preseptal cellulitis?
- Blood tests for raised inflammatory markers
- Swab of any discharge
- Contrast CT of the orbit if orbital cellulitis is suspected
What management steps should be taken for preseptal cellulitis?
- Refer to secondary care
- Oral antibiotics, usually co-amoxiclav
- Admission for observation may be required for children
What complications can arise from preseptal cellulitis?
Bacterial infection may spread into the orbit, evolving into orbital cellulitis
