Periorbital cellulitis

Background

  • Most often due to contiguous infection of soft tissues of face and eyelids
  • Most patients are <10yr
  • Rarely leads to orbital cellulitis

Periorbital vs 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)

Differential Diagnosis

Periorbital swelling

Proptosis

No proptosis

Lid Complications

Other

Evaluation

  • CT Orbit with IV contrast if:
    • Concern for orbital cellulitis
    • Unable to accurately assess vision (e.g. age <1yr)

Management

Antibiotics

Outpatient

Inpatient

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

Disposition

  • If well-appearing and afebrile consider discharge

See Also

References