Orbital cellulitis

Background

Periorbital vs orbital cellulitis

Clinical Features

  • Swelling and erythema of tissues surrounding the orbit AND:
    • Proptosis
    • Chemosis
    • Globe displacement
    • Limitation of EOM
    • Pain with eye movements
    • Double vision
    • Decreased visual acuity
    • Possible CN III, IV, VI palsies in cases of cavernous sinus involvement

Complications

Differential Diagnosis

Periorbital swelling

Proptosis

No proptosis

Lid Complications

Other

Evaluation

  • CT Orbit with IV contrast
    • Proptosis
    • Inflammation of ocular muscles
    • Subperiosteal or orbital abscess

Management

Antibiotics

Vancomycin 15-20mg/kg IV BID + (one of the following)

Consults

  • Ophthalmology consult to arrange close follow-up

Disposition

  • Admit

See Also

  • Periorbital Swelling
  • Periorbital Cellulitis

References

  1. Farooq AV et al. Fungal Orbital Cellulitis: Presenting Features, Management and Outcomes at a Referral Center. Orbit. Vol. 34 , Iss. 3,2015.
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