Equis ISSN 2398-2977

Orbit: cellulitis

Contributor(s): Graham Munroe

Introduction

  • Unilateral diffuse painful peri-ocular soft tissue swelling.
  • Cause: results from invasion of opportunistic bacteria into soft tissues around globe - secondary to small puncture wounds of eyelid/conjunctiva, orbital trauma, head trauma, or upper respiratory tract disease.
  • Signs: unilateral diffuse painful peri-ocular soft tissue swelling with ocular pain and discharge, pyrexia and third eyelid protrusion.
  • Treatment: systemic antibiotics and NSAIDs essential.
  • Prognosis: guarded.

Pathogenesis

Etiology

Predisposing factors

General
  • As above.

Pathophysiology

  • Orbital cellulitis results from the invasion of opportunistic bacteria into the soft tissues around the globe within the peri-orbita.
  • Infection can spread from the nose, mouth or paranasal sinuses via common venous drainage routes or be introduced more directly via orbital trauma or small eyelid/conjunctival puncture wounds.
  • Severe orbital inflammation or infection may eventally damage the optic nerve.
  • Direct or indirect introduction of infection into the orbit can lead to a diffuse orbital cellulitis or be localized and form a retrobulbar abscess   Orbit: retrobulbar abscess  .
  • Severe orbital inflammation often initially does not affect the eye but damage may occur to the optic nerve.
  • In advanced cases exophthalmos and exposure keratopathy can develop.

Timecourse

  • Sometimes as little as 24-48 h.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications


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