Diferencia entre revisiones de «Orbital cellulitis»
Sin resumen de edición |
Sin resumen de edición |
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| Línea 7: | Línea 7: | ||
==Clinical Features== | ==Clinical Features== | ||
#Proptosis | #Swelling and erythema of tissues surrounding the orbit AND: | ||
#Chemosis | ##Proptosis | ||
#Globe displacement | ##Chemosis | ||
#Limitation of eye movements | ##Globe displacement | ||
#Double vision | ##Limitation of eye movements | ||
#Decreased visual acuity | ##Double vision | ||
##Decreased visual acuity | |||
==Diagnosis== | ==Diagnosis== | ||
| Línea 23: | Línea 24: | ||
==Complications== | ==Complications== | ||
#Orbital Abscess | #Orbital Abscess | ||
## Pts tend to have severe proptosis, globe displacement, and appear systemically ill | ##Pts tend to have severe proptosis, globe displacement, and appear systemically ill | ||
##May be clinically indistinguishable from orbital cellulitis; requires CT | ##May be clinically indistinguishable from orbital cellulitis; requires CT | ||
#Meningitis | #Meningitis | ||
Revisión del 01:39 25 oct 2011
Background
- Must distinguish between periorbital and orbital cellulitis
- Orbital cellulitis may mimic periorbital cellulitis early in its course
- Orbital cellulitis most often due to ethmoid sinusitis
- May also be due to trauma, endophthalmitis, infection from teeth/middle ear, FB
Clinical Features
- Swelling and erythema of tissues surrounding the orbit AND:
- Proptosis
- Chemosis
- Globe displacement
- Limitation of eye movements
- Double vision
- Decreased visual acuity
Diagnosis
- CT Orbit with IV contrast
- Findings c/w orbital cellulitis:
- Proptosis
- Inflammation of ocular muscles
- Subperiosteal or orbital abscess
- Findings c/w orbital cellulitis:
Complications
- Orbital Abscess
- Pts tend to have severe proptosis, globe displacement, and appear systemically ill
- May be clinically indistinguishable from orbital cellulitis; requires CT
- Meningitis
- Cavernous sinus thrombosis
- Frontal bone osteomyelitis
- Subdural empyema
- Epidural abscess
- Brain abscess
Treatment
- Vancomycin +
- 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
- Ophthalmology consult
Disposition
- Admit
See Also
Source
- UpToDate
- Tintinalli