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Periorbital and Orbital Cellulitis, Sports Medicine

Matthew Chung, DO and Mark D. Harris, MD, MPH, MBA, MDiv, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Periorbital (preseptal) cellulitis:

    • Infection or inflammatory process of the dermis anterior (superficial) to the orbital septum

    • Rarely progresses to orbital cellulitis 1

  • Orbital (posts...

DIAGNOSIS

Clinical diagnosis is based on history, signs and symptoms, and neurologic exam. Early identification of orbital cellulitis is essential, as disease progression can lead to blindness, mening...

TREATMENT

Emergency department: 
  • Establish intravenous (IV) access, administer oxygen for serious complications, including sepsis, meningitis, and cavernous sinus thrombosis.

  • Consider vancomycin in geog...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Return-to-play guidance: 
  • Athlete and medical personnel must be able to demonstrate the following:

    • Asymptomatic with normal physical exam

    • Must pass sport-specific fu...

REFERENCES

1
Rashed F, Cannon A, Heaton PA, et al. Diagnosis, management and treatment of orbital and periorbital cellulitis in children. Emerg Nurse.  2016;24(1):30–35, quiz 37.
2
Atfeh MS, Khalil ...

CLINICAL PEARLS

  • Orbital cellulitis is any infection/inflammatory process posterior to orbital septum and can be life-threatening, whereas periorbital cellulitis is anterior to orbital septum.

  • Most comm...

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