Periorbital cellulitis

Background

• Must distinguish between these orbital and periorbital cellulitis!
  • See Periorbital vs Orbital Cellulitis
• Periorbital cellulitis most often 2/2 contiguous infection of soft tissues of face and eyelids
• Periorbital cellulitis does not lead to orbital cellulitis

Diagnosis

Signs/Symptoms

1. Swelling and erythema of tissues surrounding the orbit
2. +/- pain with eye movement
3. +/- fever
4. Lack of:
   1. Proptosis
   2. Chemosis (conj. swelling)
   3. Globe displacement
   4. Limitation of eye movements
   5. Double vision
   6. Vision loss (indicates orbital apex involvement)

Imaging

1. CT Orbit with IV contrast
   1. Indicated for suspected orbital cellulitis or in pts who cannot accurately assess vision (e.g. age <1yr)

Treatment

1. Periorbital Cellulitis
   1. Most cases (except for pts < 1yr) can be managed as outpatient w/ oral abx and daily f/u
   2. Treatment (7-10 days)
      1. Augmentin 875mg BID OR
      2. Cefpodoxime 200mg BID OR
      3. Cefdinir 600mg qd

Disposition

• • If well-appearing and afebrile consider discharge
  • If concern of hematogenous cause consider admission

See Also

• Periorbital Swelling
• Periorbital vs Orbital Cellulitis
• Orbital Cellulitis

Source

UpToDate

Tintinalli