Periorbital cellulitis: Difference between revisions
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===Background=== | ===Background=== | ||
*Must distinguish | *Must distinguish from orbital cellulitis | ||
**See [[Periorbital vs Orbital Cellulitis]] | **See [[Periorbital vs Orbital Cellulitis]] | ||
* | *Most often due to contiguous infection of soft tissues of face and eyelids | ||
* | *Does not lead to orbital cellulitis | ||
== | ==Clinical Features== | ||
#Swelling and erythema of tissues surrounding the orbit | #Swelling and erythema of tissues surrounding the orbit | ||
#+/- pain with eye movement | #+/- pain with eye movement | ||
#+/- fever | #+/- fever | ||
# | #Lack of: | ||
##Proptosis | ##Proptosis | ||
##Chemosis | ##Chemosis | ||
##Globe displacement | ##Globe displacement | ||
##Limitation of eye movements | ##Limitation of eye movements | ||
| Line 18: | Line 17: | ||
##Vision loss (indicates orbital apex involvement) | ##Vision loss (indicates orbital apex involvement) | ||
== | ==Diagnosis== | ||
#CT Orbit with IV contrast if | #CT Orbit with IV contrast if: | ||
## | ##Concern for orbital cellulitis | ||
## | ##Unable to accurately assess vision (e.g. age <1yr) | ||
==Treatment== | ==Treatment== | ||
#Augmentin 875mg BID x7-10d OR | |||
#Cefpodoxime 200mg BID x7-10d OR | |||
#Cefdinir 600mg x7-10d qd | |||
==Disposition== | ==Disposition== | ||
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==Source== | ==Source== | ||
UpToDate | *UpToDate | ||
*Tintinalli | |||
Tintinalli | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
Revision as of 01:26, 25 October 2011
Background
- Must distinguish from orbital cellulitis
- Most often due to contiguous infection of soft tissues of face and eyelids
- Does not lead to orbital cellulitis
Clinical Features
- Swelling and erythema of tissues surrounding the orbit
- +/- pain with eye movement
- +/- fever
- Lack of:
- Proptosis
- Chemosis
- Globe displacement
- Limitation of eye movements
- Double vision
- Vision loss (indicates orbital apex involvement)
Diagnosis
- CT Orbit with IV contrast if:
- Concern for orbital cellulitis
- Unable to accurately assess vision (e.g. age <1yr)
Treatment
- Augmentin 875mg BID x7-10d OR
- Cefpodoxime 200mg BID x7-10d OR
- Cefdinir 600mg x7-10d qd
Disposition
- If well-appearing and afebrile consider discharge
- If concern of hematogenous cause consider admission
See Also
Source
- UpToDate
- Tintinalli