Orbital Cellulitis

Posted by e-Medical PPT Sunday, April 17, 2011
Orbital cellulitis is a dangerous infection with potentially serious complications
It is usually caused by a bacterial infection from the sinuses (mainly ethmoid, accounting for more than 90% of all cases)
Other causes :a stye on the eyelid, recent trauma to the eyelid including bug bites, or a foreign object
In children, orbital cellulitis is usually from a sinus infection and due to the organism Hemophilus influenzae (decrease in incidence after vaccination program implentation). 
Other organisms are Staphlococcus aureus, Streptococcus pneumoniae, and Beta hemolytic streptococci

extension of infection from the periorbital structures, most commonly from the paranasal sinuses, but also from the face, globe, and lacrimal sac
Direct inoculation of the orbit from trauma or surgery (orbital decompression, dacryocystorhinostomy, eyelid surgery, strabismus surgery, retinal surgery, and intraocular surgery, have been reported as the precipitating cause of orbital cellulitis)
Hematogenous spread from bacteremia

Orbital cellulitis is infection of the soft tissues of the orbit posterior to the orbital septum, differentiating it from preseptal cellulitis, which is infection of the soft tissue of the eyelids and periocular region anterior to the orbital septum
DDx: orbital pseudotumor (inflammatory condition, responds to steroids)

Complications
Subperiostal/Orbital abscess (Chandler III-IV)
Cavernous sinus thrombosis
Hearing loss
Septicemia or blood infection
Meningitis
Optic nerve damage and blindeness

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3 Responses to Orbital Cellulitis

  1. Nice presentation, but neglects one common cause of orbital cellulitis: dento-alveolar infection.

    Classically, it can be associated with an infected upper canine tooth (though in real life, any upper tooth can be responsible).

    Definitive treatment is usually IV antibiotics, with extraction of the offending tooth. If a collection is present, incision & drainage is warranted, with intra-oral drain left in situ.

    Orbital cellulitis (secondary to dental infection) is a fairly common presentation, and is usually managed by Oral & Maxillofacial Surgeons.

    Like all dento-alveolar infections, it is becoming increasingly common, presumably not helped by the financially challenging times we live in, with people generally setting a low priority on dentistry.

     
  2. Dr.Preetha Says:
  3. a case for Orbital Cellulitis was reported to me 1 year back. The treatment went on for about 2 weeks. After one week itself there was a significant change seen.

     
  4. ralphswurld Says:
  5. Cellulitis is very serious, and can lead to necrotizing fasciitis, which is a tissue eating bacteria, or sepsis, which is also lethal. You really need to get some treatment for it or risk losing your limb. I'm sorry to be the bearer of bad news, but it would be better to pay for the treatment now rather than pay for whatever could come from not treating it. Cellulitis can enter your body from any lesion at all, be it a rash, bite, or tiiiny tiny cut.


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