Diferencia entre revisiones de «Orbital pseudotumor»
Sin resumen de edición |
Sin resumen de edición |
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==Clinical Features== | ==Clinical Features== | ||
*Proptosis<ref>Yuen, S. A. J. (2003) ‘Idiopathic Orbital Inflammation’, Archives of Ophthalmology, 121(4).</ref> | *[[Proptosis]]<ref>Yuen, S. A. J. (2003) ‘Idiopathic Orbital Inflammation’, Archives of Ophthalmology, 121(4).</ref> | ||
*Chemosis | *[[red eye|Chemosis]] | ||
*Cranial nerve palsy | *[[cranial nerve palsies|Cranial nerve palsy]] | ||
*Diplopia | *[[Diplopia]] | ||
*Pain | *[[eye pain|Pain]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Periorbital swelling DDX}} | {{Periorbital swelling DDX}} | ||
== | ==Evaluation== | ||
*CT Orbit with IV contrast | *CT Orbit with IV contrast | ||
**Evaluate for tumor vs infectious etiology | **Evaluate for tumor vs infectious etiology | ||
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==Management== | ==Management== | ||
{{Orbital Cellulitis Antibiotics}} | {{Orbital Cellulitis Antibiotics}} | ||
*Dramatic improvement with steroids in 24-28 hours (in consultation with ophthalmology) | |||
===Consults=== | ===Consults=== | ||
*Ophthalmology | *Ophthalmology | ||
==Disposition== | ==Disposition== | ||
* | *Discharge with close ophthalmology followup | ||
==Complications== | ==Complications== | ||
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<references/> | <references/> | ||
[[Category: | [[Category:Ophthalmology]] | ||
Revisión actual - 01:04 6 oct 2019
Background
- Also known as idiopathic orbital inflammation
- Swelling of any area of the orbit
- Diagnosis of exclusion
- Chronic condition characterized by orbital sclerosis and relapses[1]
Clinical Features
Differential Diagnosis
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Evaluation
- CT Orbit with IV contrast
- Evaluate for tumor vs infectious etiology
- Imaging findings may be similar to orbital cellulitis
- MRI orbit gold standard
Management
- Vancomycin 15-20mg/kg IV BID + (one of the following)
- Ampicillin/Sulbactam 3 g IV q6hr OR
- Ticarcillin/Clavulanate 3.1 g IV q4h OR
- Piperacillin/Tazobactam 4.5 g IV q6h OR
- Ceftriaxone 2 g IV q12hr OR
- Cefotaxime 2 g IV q4h
Pediatric:
- Vancomycin 15mg/kg IV q6hrs + (one of the following)
- Ampicillin/Sulbactam 50mg/kg IV q6hrs (max 3g/dose) OR
- Piperacillin/Tazobactam 100mg/kg IV q8hrs (max 4.5g) OR
- Ceftriaxone 50mg/kg IV q12hrs (max 2g/dose) OR
- Cefotaxime 50mg/kg IV q6hrs (max 2g/dose)
- Dramatic improvement with steroids in 24-28 hours (in consultation with ophthalmology)
Consults
- Ophthalmology
Disposition
- Discharge with close ophthalmology followup
Complications
- Vision loss
- Oculomotor dysfunction