Orbital cellulitis

Acute, painless loss of vision Orbital cellulitis... 

Orbital cellulitis or abscess, periorbital cellulitis, meningitis, cavernous sinus thrombosis, ethmoid or frontal sinus erosion, chronic sinusitis, and exacerbation of asthma or bronchitis... 

The oral route of drug administration may be indicated for some conditions in pediatric patients, such as in dacryocystitis and orbital or preseptal cellulitis. Young patients are able to swallow liquid suspensions and solutions more easily than oral solids (e.g., tablets or capsules). Oral medications are the most reliable form of dosing and delivery and continue to be the mainstay in pediatric drug therapy. 

Staphylococcus auretAs Skin abscesses, impetigo, cellulitis, pneumonia, septic arthritis, osteomyelitis, toxic-shock syndrome, enterotoxin food poisoning, surgical infections Blepharitis, hordeolum, conjunctivitis, dacryocystitis, corneal ulcer, preseptal and orbital cellulitis, endophthalmitis... 

Orbital cellulitis is an infection of the orbital contents posterior to the orbital septum. Streptococci and staphylococci are common bacterial isolates. Many regimens exist for empiric treatment of this disease, but no regimen has been tested in clinical trials. Intravenous nafcillin can be used as initial therapy for orbital cellulitis, especially when a staphylococcal infection is suspected or known (see Table 11-1). 

Givner LB. Periorbital versus orbital cellulitis. Pediatr Infect Dis J 2002 21 1157-1158. 

Preseptal or periorbital cellulitis is an infectious process involving lid structures anterior to the orbital septum. The condition generally occurs due to one of three clinical scenarios (1) secondary to a localized infection or an inflammation of the eyelids or adjacent structures (i.e., sinusitis, conjunctivitis, blepharitis, and/or internal hordeolum), (2) secondary to eyelid or fecial trauma, and (3) after an upper respiratory tract infection. 

Modified from Jones DB, SteinkuUer PG. Microbial preseptal and orbital cellulitis. In Tasman W, Jaeger EA, eds. Duane s clinical ophthalmology, vol. 4. Philadelphia JB Lippincott, 1993 1-24 and Holdeman NR. Preseptal ceUulitis/orbital ceUulitis. In Onofrey BE, Skorin Jr L, Holdeman NR, eds. Ocular therapeutics handbook a clinical manual, ed. 2. Philadelphia Lippincott WiUiams and Wilkins, 2005 189-193 )... 

As previously stated,//, influenzae is no longer a major cause of cellulitis in children. However, when present, the condition is characterized by significant fever, leukocytosis, and unilateral hyperemia and edema of the eyelids. There is a sharply demarcated dark purple discoloration of the eyelid skin and adnexal area. Mild conjunctival hyperemia and chemosis may also occur. Unless the patient has received antibiotics, blood cultures are the most effective means of establishing the diagnosis. If meningeal signs are present, a lumbar puncture should be performed, because 12% to 25% of patients with Haemophilus preseptal or orbital cellulitis have concomitant meningitis. 

A 63-year-old woman underwent phacoemulsification and lens implantation under sub-tenon block. After the local anesthetic was injected, the eye was prepared with an aqueous solution of povidone iodine and the surgery proceeded uneventfully. At the end, gentamicin and betamethasone were injected subconjunctivally. Over the next few days she developed orbital cellulitis, requiring intravenous antibiotics. 

Dahlmann AH, Appaswamy S, Headon MP. Orbital cellulitis following sub-Tenon s anaesthesia. Eye 2002 16(2) 200-1. 

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