Periorbital cellulitis
Encyclopedia
Periorbital cellulitis, also known as preseptal cellulitis (and not to be confused with orbital cellulitis
, which is behind the septum), is an inflammation and infection of the eyelid and portions of skin around the eye, anterior to the orbital septum
. It may be caused by breaks in the skin around the eye, and subsequent spread to the eyelid; infection of the sinuses around the nose (sinusitis); or from spread of an infection elsewhere through the blood.
, which is an emergency and requires intravenous (IV) antibiotics. In contrast to orbital cellulitis, patients with periorbital cellulitis do not have bulging of the eye (proptosis), limited eye movement (ophthalmoplegia), pain on eye movement, or loss of vision. If any of these features is present, one must assume that the patient has orbital cellulitis and begin treatment with IV antibiotics. CT
scan may be done to delineate the extension of the infection.
It can be caused by sleeping overnight with make-up on the eyes. This can lead to microscopic pieces of make-up in the eyelid for days causing infection.
Affected individuals may experience the following;
swelling,
redness,
discharge,
pain,
shut eye,
conjunctival injection,
fever (mild), slightly blurred vision, teary eyes, and some reduction in vision.
Typical signs include periorbital erythema, induration, tenderness and warmth.
and streptococcus
bacteria are commonly implicated.
The advent of the Haemophilus influenzae
vaccine has dramatically decreased the incidence.
Spider or other insect bites can also be causal.
and clindamycin
are common choices.
Warm to hot compresses help with pain and inflammation. Antibiotic eye drop
s keep eye moist and prevent infection to eye or other areas. A lubricant, such as petroleum jelly applied with clean cotton swab, provides relief to dry skin on eyelid due to wiping and fevered skin, as well as making it easier to wipe off drainage and/or prevent crusting. Definitely seek medical attention if symptoms persist beyond 2–3 days.
Orbital cellulitis
Orbital cellulitisis an infection of eye tissues posterior to the orbital septum. It most commonly refers to an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood...
, which is behind the septum), is an inflammation and infection of the eyelid and portions of skin around the eye, anterior to the orbital septum
Orbital septum
The orbital septum is a membranous sheet that acts as the anterior boundary of the orbit. It extends from the orbital rims to the eyelids...
. It may be caused by breaks in the skin around the eye, and subsequent spread to the eyelid; infection of the sinuses around the nose (sinusitis); or from spread of an infection elsewhere through the blood.
Signs and symptoms
Periorbital cellulitis must be differentiated from orbital cellulitisOrbital cellulitis
Orbital cellulitisis an infection of eye tissues posterior to the orbital septum. It most commonly refers to an acute spread of infection into the eye socket from either the adjacent sinuses or through the blood...
, which is an emergency and requires intravenous (IV) antibiotics. In contrast to orbital cellulitis, patients with periorbital cellulitis do not have bulging of the eye (proptosis), limited eye movement (ophthalmoplegia), pain on eye movement, or loss of vision. If any of these features is present, one must assume that the patient has orbital cellulitis and begin treatment with IV antibiotics. CT
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
scan may be done to delineate the extension of the infection.
It can be caused by sleeping overnight with make-up on the eyes. This can lead to microscopic pieces of make-up in the eyelid for days causing infection.
Affected individuals may experience the following;
swelling,
redness,
discharge,
pain,
shut eye,
conjunctival injection,
fever (mild), slightly blurred vision, teary eyes, and some reduction in vision.
Typical signs include periorbital erythema, induration, tenderness and warmth.
Causes
StaphylococcusStaphylococcus
Staphylococcus is a genus of Gram-positive bacteria. Under the microscope they appear round , and form in grape-like clusters....
and streptococcus
Streptococcus
Streptococcus is a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning...
bacteria are commonly implicated.
The advent of the Haemophilus influenzae
Haemophilus influenzae
Haemophilus influenzae, formerly called Pfeiffer's bacillus or Bacillus influenzae, Gram-negative, rod-shaped bacterium first described in 1892 by Richard Pfeiffer during an influenza pandemic. A member of the Pasteurellaceae family, it is generally aerobic, but can grow as a facultative anaerobe. H...
vaccine has dramatically decreased the incidence.
Spider or other insect bites can also be causal.
Treatment
Antibiotics are aimed at gram positive bacteria. Cephalexin, dicloxacillinDicloxacillin
Dicloxacillin is a narrow-spectrum beta-lactam antibiotic of the penicillin class. It is used to treat infections caused by susceptible Gram-positive bacteria. It is active against beta-lactamase-producing organisms such as Staphylococcus aureus, which would otherwise be resistant to most...
and clindamycin
Clindamycin
Clindamycin rINN is a lincosamide antibiotic. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria...
are common choices.
Warm to hot compresses help with pain and inflammation. Antibiotic eye drop
Eye drop
Eye drops are saline-containing drops used as a route to administer medication in the eye. Depending on the condition being treated, they may contain steroids, antihistamines, sympathomimetics, beta receptor blockers, parasympathomimetics, parasympatholytics, prostaglandins, non-steroidal...
s keep eye moist and prevent infection to eye or other areas. A lubricant, such as petroleum jelly applied with clean cotton swab, provides relief to dry skin on eyelid due to wiping and fevered skin, as well as making it easier to wipe off drainage and/or prevent crusting. Definitely seek medical attention if symptoms persist beyond 2–3 days.