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Cellulitis, Orbital

Frances J Boly, DO and Hillary Kieran Deveaux, MBBS Reviewed 04/2024
 


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 septu...

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. 

MEDICATION

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

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

SNOMED

194005002 orbital cellulitis (disorder) 

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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