orbital cellulitis

Orbital cellulitis is a serious bacterial infection that affects the tissue around the eye and eye socket [1]. It causes inflammation and discoloration or redness outside and around the eye [1].

The terms orbital cellulitis and periorbital cellulitis refer to an inflammation and infection of the tissue and skin surrounding the eye [2]. This condition can be caused by a bacterial infection that spreads from adjacent sinuses, leading to inflammation of the eye tissues posterior to the orbital septum [10].

Symptoms of orbital cellulitis include:

• Swelling and redness of the eyelid and surrounding soft tissues
• Conjunctival hyperemia and chemosis (redness and swelling of the conjunctiva)
• Decreased vision
• Pain when moving the eye
• Fever
• Bulging eyes
• Reduced eye movement
• Double vision

These symptoms can be severe and may lead to sudden loss of vision, erythema (redness), edema (swelling), decreased eye movement, and pain [10].

Orbital cellulitis is a medical emergency that requires prompt treatment. Treatment typically involves intravenous antibiotics, observation, and surgical intervention when necessary [10]. Early recognition and treatment are crucial to prevent serious complications and preserve vision.

References: [1] Context result 1 [2] Context result 2 [10] Context result 10

Orbital cellulitis is a serious infection that affects the tissues surrounding the eye, including the eyelids, eyebrow, cheek, and orbit. The signs and symptoms of this condition can be quite distressing and require prompt medical attention.

Common Signs and Symptoms:

• Painful swelling: Swelling and pain in the upper and lower eyelid, as well as the eyebrow and cheek [2][5]
• Bulging eyes: Proptosis or forward displacement of the eye is a common symptom [6][7]
• Decreased vision: Vision problems can occur due to the infection affecting the surrounding tissues [5][7]
• Pain when moving the eye: Pain and discomfort when moving the eye in any direction [2][5]
• Fever: A high fever is often present, indicating a bacterial infection [8]

Other Symptoms:

• Anterior displacement of the eyeball: The eyeball may appear to be pushed forward due to swelling and inflammation [7]
• Double vision (diplopia): Difficulty seeing two images or double vision can occur due to the infection affecting the surrounding tissues [7]
• Decrease in ocular motility: Reduced movement of the eye, making it difficult to move the eye in any direction [7]

Important Note: If you suspect that you or someone else has orbital cellulitis, seek immediate medical attention. This condition can lead to serious complications if left untreated.

References: [1] Not available [2] 2. Symptoms · Painful swelling of upper and lower eyelid, and possibly the eyebrow and cheek · Bulging eyes · Decreased vision · Pain when moving the eye · Fever, often ... [3] Not available [4] by LA Mawn · Cited by 3 — The presence of the following signs is suggestive of orbital involvement: proptosis, chemosis, pain with eye movements, ophthalmoplegia, optic ... [5] Sep 10, 2022 — Symptoms · Painful swelling of upper and lower eyelid, and possibly the eyebrow and cheek · Bulging eyes · Decreased vision · Pain when moving the ... [6] Feb 14, 2019 — Pain, swelling, and proptosis, which is the protrusion or forward displacement of the eye, are common symptoms of orbital cellulitis. Other ... [7] Aug 14, 2024 — Symptoms of orbital cellulitis · Anterior displacement of the eyeball · Double vision (diplopia) · Decrease in ocular motility · Fever · Loss of ... [8] by I Baiu · 2020 · Cited by 30 — Symptoms of orbital cellulitis include swelling, redness, pain, and tenderness to touch around one eye, although these may be less obvious than ...

Orbital cellulitis can be diagnosed through a combination of clinical examination, medical history review, and imaging tests.

Clinical Examination A healthcare provider can usually recognize orbital cellulitis without the need for diagnostic tests. However, they may perform a physical examination to look for signs such as proptosis (bulging eye), chemosis (swelling around the eye), pain with eye movements, ophthalmoplegia (weakness or paralysis of the extraocular muscles), and optic nerve involvement [1]. They may also check for fever, leukocytosis (elevated white blood cell count), and lethargy.

Imaging Tests Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI) are usually done to confirm the diagnosis of orbital cellulitis. These tests can help identify the extent of the infection and any potential complications [2]. High-resolution contrast CT scanning of the orbit with axial and coronal views is particularly helpful in visualizing the orbital contents [4].

Other Diagnostic Tests In some cases, additional diagnostic tests may be ordered to determine the cause of the infection. These can include:

• Examination of the teeth and mouth
• CT or MRI of the nasal sinuses
• Blood tests to check for infection in the bloodstream

It's worth noting that prompt diagnosis of orbital cellulitis is critical because the condition can lead to permanent vision problems and blindness [15]. Therefore, a comprehensive approach that includes a physical examination, medical history review, and imaging tests is essential for effective treatment.

References:

[1] Context result 1 [2] Context result 2 [4] Context result 4 [15] Context result 15

Orbital cellulitis is a serious infection that requires prompt medical attention. The primary goal of drug treatment for orbital cellulitis is to eliminate the underlying bacterial infection and prevent further complications.

Antibiotic Therapy

The cornerstone of antibiotic therapy for orbital cellulitis is intravenous antibiotics, which are administered through an IV (intravenously). The choice of antibiotic depends on various factors, including the severity of the infection, the age and health status of the patient, and any allergies or sensitivities to certain medications.

• Third-generation cephalosporins, such as cefotaxime, are often used as a first-line treatment for orbital cellulitis [2].
• Broad-spectrum antibiotics, like piperacillin-tazobactam, ticarcillin-clavulanate, and ceftriaxone, may also be prescribed to cover a wide range of bacteria [5].
• For penicillin-allergic patients, vancomycin is an alternative option [5].

Duration of Treatment

The duration of antibiotic therapy for orbital cellulitis typically ranges from 7 to 10 days. However, this may vary depending on the individual case and the response to treatment.

• Cefalexin, a first-generation cephalosporin, is often prescribed orally (PO) for 7 to 10 days [9].
• Amoxicillin/clavulanate is another oral antibiotic option for treating orbital cellulitis in certain cases [9].

It's essential to note that while antibiotics are crucial in managing orbital cellulitis, they may not be sufficient on their own. Surgical debridement and drainage of the abscess or subperiosteal space may also be necessary to relieve pressure and promote healing [4].

Orbital cellulitis is a serious infection that requires prompt diagnosis and treatment to prevent complications. The differential diagnosis for orbital cellulitis includes several conditions that can present with similar symptoms.

Key Conditions to Consider

• Preseptal cellulitis: This is a milder form of eyelid cellulitis that does not involve the orbit. It is often caused by bacterial or viral infections, and may be accompanied by swelling, redness, and pain in the eyelids.
• Blepharitis: An inflammation of the eyelids that can cause redness, swelling, and crusting on the eyelashes.
• Conjunctivitis: An infection of the conjunctiva, which is the thin membrane covering the white part of the eye. It can be caused by bacteria, viruses, or allergens.
• Dermatitis: A skin condition that can cause redness, itching, and swelling on the eyelids.

Other Conditions to Consider

• Angioedema: A rare but serious allergic reaction that can cause rapid swelling of the face, lips, tongue, and eyelids.
• Cavernous sinus thrombosis: A blood clot in the cavernous sinus, which is a group of veins behind the eye. This condition can be life-threatening if left untreated.

Important Considerations

Orbital cellulitis is a medical emergency that requires prompt attention from a healthcare professional. It is essential to distinguish orbital cellulitis from preseptal cellulitis and other causes of eyelid swelling, as the former requires immediate treatment to prevent serious complications.

References:

• [1] Orbital cellulitis should be suspected in any patient with adnexal, facial, or dental infection when orbital pain, proptosis, limitation of extraocular movements, or vision changes are present.
• [2] The differential diagnosis includes preseptal cellulitis, blepharitis, conjunctivitis, and dermatitis.
• [3] Differential Diagnosis. The differential diagnosis includes: Angioedema.
• [4] Conditions to consider in the differential diagnosis of periorbital cellulitis include the following: Angioedema.
• [5] Preseptal cellulitis is generally a mild condition that rarely leads to serious complications, whereas orbital cellulitis may cause loss of vision or even death if left untreated.