Orbital cellulitis

Question 1

what is it?

Answer 1

result of an infection affecting the fat and muscles posterior to the orbital septum, within the orbit but not involving the globe

Question 2

cause

Answer 2

URTI from sinuses

Question 3

what is pre-orbital cellulitis

Answer 3

a less serious superficial infection anterior to the orbital septum, resulting from a superficial tissue injury (chalazion, insect bite etc…). Periorbital cellulitis can progress to orbital cellulitis.

Question 4

RF

Answer 4

Childhood
Mean age of hospitalisation 7-12 years
Previous sinus infection
Lack of Haemophilus influenzae type b (Hib) vaccination
Recent eyelid infection/ insect bite on eyelid (periorbital cellulitis)
Ear or facial infection

Question 5

presentations

Answer 5

Redness and swelling around the eye
Severe ocular pain
Visual disturbance
Proptosis
Ophthalmoplegia/pain with eye movements
Eyelid oedema and ptosis
Drowsiness +/- Nausea/vomiting in meningeal involvement (Rare)

Question 6

what is not consistent with preseptal cellulitis

Answer 6

reduced visual acuity, proptosis, ophthalmoplegia/pain with eye movement

Question 7

Ix

Answer 7

FBC

Exam

CT with contrast

Blood cult

Question 8

Most common causing organisms

Answer 8

Streptococcus, Staphylococcus aureus, Haemophilus influenzae B.

Question 9

mx

Answer 9

admit

iv abx