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Cellulitis, Orbital

Robert Thomas Carlisle, MD, MPH Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Acute, severe, vision-threatening infection of orbital contents posterior to orbital septum. Preseptal (previously referred to as periorbital) cellulitis is anterior to the septum. D...

DIAGNOSIS

HISTORY

  • Complaints of acute onset red, swollen, tender eye or eyelid, and pain with eye movements

  • History of surgery, trauma, sinus or upper respiratory infection, dental infection

  • Malaise, fev...

TREATMENT

Admit patients with orbital cellulitis for monitoring and treatment with broad-spectrum IV antibiotics (1). 

MEDICATION

  • Empiric antibiotic therapy to cover pathogens associated with acute sinu...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Serial visual acuity testing and slit lamp exams 
ALERT

Bedside exam q4h is indicated, as complications can develop rapidly.

 

PATIENT EDUCATION

  • Main...

REFERENCES

1
1 Chadha NK. An evidence-based staging system for orbital infections from acute rhinosinusitis. Laryngoscope.  2012;122(Suppl 4):S95–S96. {L-End} {L-End} [View Abstract on OvidMedl...

CODES

ICD10

  • H05.019 Cellulitis of unspecified orbit

  • H05.011 Cellulitis of right orbit

  • H05.012 Cellulitis of left orbit

  • H05.013 Cellulitis of bilateral orbits

ICD9

376.01 Orbital cellulitis 

SNOMED

194005002 o...

CLINICAL PEARLS

  • Most orbital cellulitis cases result from sinusitis.

  • MRSA orbital cellulitis may present without an associated upper respiratory infection.

  • CT of orbits and sinuses with axial and corona...

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