Periorbital cellulitis

Background

• Must distinguish from orbital cellulitis
  • See Periorbital vs Orbital Cellulitis
• Most often due to contiguous infection of soft tissues of face and eyelids
• Most pts are <10yr
• Does not lead to orbital cellulitis

Clinical Features

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

Diagnosis

1. CT Orbit with IV contrast if:
   1. Concern for orbital cellulitis
   2. Unable to accurately assess vision (e.g. age <1yr)

Treatment

1. Augmentin 875mg BID x7-10d OR
2. Cefpodoxime 200mg BID x7-10d OR
3. Cefdinir 600mg x7-10d 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