Professional Documents
Culture Documents
PE: WDWN, fussy and ill, but otherwise non-toxic. Left upper and
lower eyelids appear significantly edematous, erythematous, and
tender to palpation. EOM appeared intact but exam limited due to
pain. No apparent chemosis, proptosis, or purulent discharge
present.
Noma et al. TOOPHTJ The Open Ophthalmology Journal 4.1 (2010): 71-75; Uptodate
Etiology of Orbital Cellulitis
1. Extension of primary infection from paranasal sinuses
Hauser, A., and S. Fogarasi. "Periorbital and Orbital Cellulitis." Pediatrics in Review 31.6 (2010): 242-49
Epidemiology
Preseptal cellulitis is more common that orbital cellulitis
Staphylococcus aureus 9%
Streptococcus pneumoniae 4%
Botting et al International Journal of Pediatric Otorhinolaryngology 72.3 (2008): 377-83; Seltz et al Pediatrics 127.3 (2011)
Clinical Presentation
Proptosis
Chemosis
Visual impairment
Hauser, A., and S. Fogarasi. "Periorbital and Orbital Cellulitis." Pediatrics in Review 31.6 (2010): 242-49
Chandlers Classification
Bedwell and Bauman "Management of Pediatric Orbital Cellulitis and Abscess." Current Opinion in Otolaryngology & Head and Neck Surgery 19.6 (2011) 467-73
Medical Management
Bedwell and Bauman "Management of Pediatric Orbital Cellulitis and Abscess." Current Opinion in Otolaryngology & Head and Neck Surgery 19.6 (2011) 467-73
Surgical Management
Indications
Evidence of impaired visual acuity, elevated IOP, opthalmoplegia, proptosis 5 mm, abscess > 10 mm
Goals: drain abscess, release pressure on orbit, obtain cultures to guide antibiotics
Surgical interventions:
Johnson, Jonas T., Clark A. Rosen, and Byron J. Bailey. "Chapter 33: Acute Rhinosinusitis." Bailey's Head and Neck Surgery--otolaryngology.
Case
Most cases respond well to antibiotic therapy (PO Clindamycin; IV Vanc + Zosyn
2. Botting, A.m., D. Mcintosh, and M. Mahadevan. "Paediatric Pre- and Post-septal Peri-orbital Infections Are Different Diseases." International Journal of Pediatric
3. Hauser, A., and S. Fogarasi. "Periorbital and Orbital Cellulitis." Pediatrics in Review 31.6 (2010): 242-49.
4. Johnson, Jonas T., Clark A. Rosen, and Byron J. Bailey. "Chapter 33: Acute Rhinosinusitis." Bailey's Head and Neck Surgery--otolaryngology. Philadelphia: Wolters
5. Liu, C., A. Bayer, S. E. Cosgrove, R. S. Daum, S. K. Fridkin, R. J. Gorwitz, S. L. Kaplan, A. W. Karchmer, D. P. Levine, B. E. Murray, M. J. Rybak, D. A. Talan, and
H. F. Chambers. "Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus
Infections in Adults and Children." Clinical Infectious Diseases 52.3 (2011): n. pag. Web.
6. Noma, Kazunami, Yasuhiro Takahashi, Igal Leibovitch, and Hirohiko Kakizaki. "Transcutaneous Blepharoptosis Surgery: Simultaneous Advancement of the Levator
Aponeurosis and Mllers Muscle (Levator Resection)." TOOPHTJ The Open Ophthalmology Journal 4.1 (2010): 71-75. Web.
7. Seltz, L. B., J. Smith, V. D. Durairaj, R. Enzenauer, and J. Todd. "Microbiology and Antibiotic Management of Orbital Cellulitis." Pediatrics 127.3 (2011): n. pag.