Periorbital cellulitis

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

In endophtalmitis, culture results of the vitreous aspirate can guide specific therapy. Periorbital cellulitis is treated with amoxi/ampicillin plus beta-lactamase inhibitor or a second generation cephalosporin. 

Al-Nammari S, Robertson B, Ferguson C. Towards evidence based emergency medicine best BETs from the Manchester Royal Infirmary. Should a child with preseptal periorbital cellulitis be treated with intravenous or oral antibiotics Emerg Med J 2007 24 128-129. 

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. 

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

A 43-year-old woman was admitted to hospital with the sudden onset of tongue and periorbital swelling. She had commenced a course of oral flucloxacillin for cellulitis of the left hand. Regular medications included propranolol, lansoprazole, and fexofenadine. She had no known traditional risk factors for coronary artery disease. A diagnosis of anaphylaxis was made probably due to flucloxacillin. She was first treated with intravenous hydrocortisone and chlorphenamine. Despite this treatment, she became profoundly hypotensive. This prompted the intramuscular administration of 0.5mg adrenaline (0.5mL 1 1000 solution). There was inadequate clinical response to the first dose, and so, a second 0.5 mL dose was administered. This resulted in normalization of blood pressure... 

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