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| ===Background===
| | #REDIRECT[[Orbital cellulitis]] |
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| * Important to distinguish between these two conditions
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| * Orbital cellulitis may mimic periorbital cellulitis early in its course!
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| * Orbital cellulitis most often 2/2 ethmoid sinusitis
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| * May also be 2/2 orbital trauma, endophthalmitis, infectious infection from teeth / middle ear
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| * Periorbital cellulitis most often 2/2 contiguous infection of soft tissues of face and eyelids
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| * Periorbital cellulitis does not lead to orbital cellulitis
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| ===Signs/Symptoms ===
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| * Periorbital Cellulitis
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| * Swelling and erythema of tissues surrounding the orbit
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| * +/- pain with eye movement
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| * +/- fever
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| * Orbital Cellulitis
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| * All of the above plus:
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| * Proptosis
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| * Chemosis (conj. swelling)
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| * Globe displacement
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| * Limitation of eye movements
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| * Double vision
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| * Vision loss (indicates orbital apex involvement)
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| ===Diagnosis===
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| * CT Orbit with IV contrast
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| * Indicated for suspected orbital cellulitis or in pts who cannot accurately assess vision (e.g. age <1yr)
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| * Findings c/w orbital cellulitis:
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| * Proptosis
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| * Inflammation of ocular muscles
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| * Subperiosteal or orbital abscess
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| == ==
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| ==Complications==
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| * Subperiosteal Abscess
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| * Must be distinguished from orbital cellulitis based on CT
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| * Orbital Abscess
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| * Pts tend to have severe proptosis, globe displacement, and appear systemically ill
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| * May be clinically indistinguishable from orbital cellulitis; requires CT
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| * Meningitis
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| * Cavernous sinus thrombosis
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| ==Treatment==
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| * Periorbital Cellulitis
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| * Most cases (except for pts < 1yr) can be managed as outpatient w/ oral abx and daily f/u
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| * Treatment (7-10 days)
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| * Augmentin 875mg BID OR
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| * Cefpodoxime 200mg BID OR
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| * Cefdinir 600mg qd
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| * Orbital Cellulitis
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| * Vancomycin +
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| * Ampicillin-sulbactam 3 g IV q6hr OR
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| * Ticarcillin-clavulanate 3.1 g IV q4h OR
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| * Piperacillin-tazobactam 4.5 g IV q6h OR
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| * Ceftriaxone 2 g IV q12hr OR
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| * Cefotaxime 2 g IV q4h
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| See Also
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| Ophtho: Periorbital Swelling
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| ===Source: UpToDate===
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| [[Category:Ophtho]]
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