Orbital Cellulitis Flashcards
what is it?
Bacterial or fungal infection of soft tissues posterior to the orbital septum
(fat, connective tissue, muscle)
Etiology/associations
- Extension from adjacent infection (sinitus, hordeolum, dental infection)
- Post op
- Ocular trauma such as orbital fracture
- Staph, strep, influenzae most commonly
- Less commonly- a fungus. Seen in immunosuppressant patients.
Who is this common in?
Depends on etiology, but more common in children
Laterality?
Unilateral
Symptoms
Eyelid swelling, red, tender, painful, and hot. Red eye Displaced, bulging eye Double vision due to proptosis Pain on EOMs Fever
If fungal, expect to see
Black mucous discharge from nose and eyes
Signs
Eyelid edema, erythema, tender, pain
Conj Chemosis and injection- conj swollen like balloon
Proptosis
Globe displacement
Restricted EOM and pain with eye movement
Fever
Funcal- back discharge. Scabby tissue. Sign of fungal cellulitis.
Conj chemosis
Conj swollen like balloon
Complications
Compression on the globe or ON
Orbital Abcess
Cavernous sinus thrombosis
Meningitis
Management
Refer to ER with note: Suspected orbital cellulitis. Recommend CT/MRI. Stat IV antibiotic Tx.
If pt is immunosuppressant, add “rule out fungal infection”
What is the most common cause of orbital cellulitis?
Extension of sinusitis
Why might pt be immunosuppressant and more susceptible to fungal orbital cellulitis?
HIV, diabetes, chemotherapy, high dose steroid therapy, organ transplant.
