Orbital cellulitis

(Redirected from Orbital Cellulitis)

Background

Periorbital vs orbital cellulitis

Clinical Features

Orbital Cellulitiswith retrobulbar hematoma and proptosis
Left orbital cellulitis secondary to penetrating dog bite.
  • Swelling and erythema of tissues surrounding the orbit AND:
    • Proptosis
    • Chemosis
    • Globe displacement
    • Limitation of EOM
    • Pain with eye movements
    • Double vision
    • Decreased visual acuity
    • Possible CN III, IV, VI palsies in cases of cavernous sinus involvement

Differential Diagnosis

Periorbital swelling

Proptosis

No proptosis

Lid Complications

Other

Evaluation

Left medial subperiosteal abscess with associated ethmoid sinusitis.
  • CT Orbit with IV contrast

Findings consistent with orbital cellulitis

  • Proptosis
  • Inflammation of ocular muscles
  • Subperiosteal or orbital abscess

Management

Antibiotics

Vancomycin 15-20mg/kg IV BID + (one of the following)

Consults

  • Ophthalmology consult to arrange close follow-up

Disposition

  • Admit

Complications

  • Orbital abscess
    • Patients tend to have severe proptosis, globe displacement, and appear systemically ill
    • May be clinically indistinguishable from orbital cellulitis; requires CT
  • Meningitis
  • Cavernous sinus thrombosis
  • Frontal bone osteomyelitis
  • Subdural empyema
  • Epidural abscess
  • Brain abscess

See Also

References

  1. Farooq AV et al. Fungal Orbital Cellulitis: Presenting Features, Management and Outcomes at a Referral Center. Orbit. Vol. 34 , Iss. 3,2015.

Authors:

Ross Donaldson