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Cellulitis, Orbital

Robert T. Carlisle, MD, MPH and Paul M. Allred, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Acute, severe, vision-threatening infection of orbital contents posterior to the orbital septum.

  • Preseptal (previously referred to as periorbital) cellulitis is anterior to the septum...

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 (3). 

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
El Mograbi A, Ritter A, Najjar E, et al. Orbital complications of rhinosinusitis in the adult population: analysis of cases presenting to a tertiary medical center over a 13-year period. A...

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 cases of orbital cellulitis arise from sinusitis.

  • CT of orbits and sinuses with axial and coronal views with and without contrast is diagnostic modality of choice.

  • Patients with orb...

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