Periorbital cellulitis - Revision history

Danbot: Strip excess bold

2026-03-22T09:32:31Z

Strip excess bold

← Older revision		Revision as of 09:32, 22 March 2026
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	==Background==		==Background==
	[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]		[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]
	*Also known as ~~'''~~preseptal cellulitis~~'''~~ — infection anterior to the orbital septum		*Also known as preseptal cellulitis — infection anterior to the orbital septum
	*Most often due to contiguous spread from [[sinusitis]], skin infection, insect bite, or local trauma		*Most often due to contiguous spread from [[sinusitis]], skin infection, insect bite, or local trauma
	*Most patients are <10 years old		*Most patients are <10 years old
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	*Eyelid swelling, erythema, tenderness, warmth		*Eyelid swelling, erythema, tenderness, warmth
	*+/- [[fever]]		*+/- [[fever]]
	*~~'''~~Key distinguishing features from [[orbital cellulitis]] (all ABSENT in preseptal):~~'''~~		*Key distinguishing features from [[orbital cellulitis]] (all ABSENT in preseptal):
	**[[Proptosis]]		**[[Proptosis]]
	**[[red eye\|Chemosis]]		**[[red eye\|Chemosis]]
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	[[File:RtmaxobitinfectteethCT.png\|thumb\|Periorbital cellulitis caused by a dental infection (also causing maxillary [[sinusitis]]).]]		[[File:RtmaxobitinfectteethCT.png\|thumb\|Periorbital cellulitis caused by a dental infection (also causing maxillary [[sinusitis]]).]]
	*Visual acuity, pupil exam, extraocular movement assessment — essential to distinguish from orbital cellulitis		*Visual acuity, pupil exam, extraocular movement assessment — essential to distinguish from orbital cellulitis
	*~~'''~~CT orbit with IV contrast~~'''~~ if:		*CT orbit with IV contrast if:
	**Equivocal exam (unable to fully assess proptosis, EOM, or pain with eye movement)		**Equivocal exam (unable to fully assess proptosis, EOM, or pain with eye movement)
	**Unable to accurately assess vision (e.g. age <1 year)		**Unable to accurately assess vision (e.g. age <1 year)
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	==Disposition==		==Disposition==
	*~~'''~~Outpatient:~~'''~~ Well-appearing, afebrile, mild disease, reliable follow-up in 24 hours		*Outpatient: Well-appearing, afebrile, mild disease, reliable follow-up in 24 hours
	*~~'''~~Admit:~~'''~~ Age <1 year, toxic-appearing, febrile, unable to tolerate PO, failed outpatient therapy, concern for orbital involvement		*Admit: Age <1 year, toxic-appearing, febrile, unable to tolerate PO, failed outpatient therapy, concern for orbital involvement
	*~~'''~~Return precautions:~~'''~~ Worsening swelling, fever, vision changes, pain with eye movement, inability to open eye		*Return precautions: Worsening swelling, fever, vision changes, pain with eye movement, inability to open eye

	==See Also==		==See Also==

Danbot: Expand: organisms, CT indications, admission criteria, return precautions

2026-03-21T01:46:52Z

Expand: organisms, CT indications, admission criteria, return precautions

← Older revision		Revision as of 01:46, 21 March 2026
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	==Background==		==Background==
	[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]		[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]
	*Also known as "preseptal cellulitis"		*Also known as '''preseptal cellulitis''' — infection anterior to the orbital septum
	*Most often due to contiguous infection ~~of soft tissues of face and eyelids~~		*Most often due to contiguous spread from [[sinusitis]], skin infection, insect bite, or local trauma
	*Most patients are <~~10yr~~		*Most patients are <10 years old
	*Rarely ~~leads~~ to orbital cellulitis		*Rarely progresses to [[orbital cellulitis]], but must be distinguished from it (see table below)
			*Common organisms: ''S. aureus'', ''S. pneumoniae'', ''S. pyogenes'', ''H. influenzae'' (in unvaccinated)

	{{Periorbital vs orbital cellulitis}}		{{Periorbital vs orbital cellulitis}}
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	==Clinical Features==		==Clinical Features==
	[[File:PMC3214412 IJO-59-431-g007.png\|thumb\|Periorbital cellulitis]].		[[File:PMC3214412 IJO-59-431-g007.png\|thumb\|Periorbital cellulitis]].
	*~~Swelling~~, tenderness, ~~and erythema of eyelids and superficial tissues surrounding the orbit~~		*Eyelid swelling, erythema, tenderness, warmth
	*+/- [[fever]]		*+/- [[fever]]
	*'''~~Lack of~~''':		*'''Key distinguishing features from [[orbital cellulitis]] (all ABSENT in preseptal):'''
	**[[Proptosis]]		**[[Proptosis]]
	**[[red eye\|Chemosis]]		**[[red eye\|Chemosis]]
	**Globe displacement		**Globe displacement
	**Limitation of ~~eye~~ movements		**Limitation of extraocular movements
	**Pain with eye movement		**Pain with eye movement
	**[[~~diplopia\|Double vision~~]]		**[[Diplopia]]
	**[[Vision loss]] ~~(indicates orbital apex involvement)~~		**[[Vision loss]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	[[File:RtmaxobitinfectteethCT.png\|thumb\|Periorbital cellulitis caused by a dental infection (also causing maxillary [[sinusitis]]).]]		[[File:RtmaxobitinfectteethCT.png\|thumb\|Periorbital cellulitis caused by a dental infection (also causing maxillary [[sinusitis]]).]]
	*CT ~~Orbit~~ with IV contrast if:		*Visual acuity, pupil exam, extraocular movement assessment — essential to distinguish from orbital cellulitis
	**~~Concern for orbital cellulitis-i.e. equivocal assessment of~~ proptosis, ~~red eye~~, ~~EOM function~~ or pain w/ eye movement		*'''CT orbit with IV contrast''' if:
	**Unable to accurately assess vision (e.g. age <~~1yr~~)		**Equivocal exam (unable to fully assess proptosis, EOM, or pain with eye movement)
			**Unable to accurately assess vision (e.g. age <1 year)
			**Toxic-appearing or not improving on antibiotics
			**Concern for orbital abscess (subperiosteal or orbital)
			*Blood cultures if febrile or toxic-appearing

	==Management==		==Management==
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	==Disposition==		==Disposition==
	*~~If well~~-appearing ~~and~~ afebrile ~~consider discharge~~		*'''Outpatient:''' Well-appearing, afebrile, mild disease, reliable follow-up in 24 hours
			*'''Admit:''' Age <1 year, toxic-appearing, febrile, unable to tolerate PO, failed outpatient therapy, concern for orbital involvement
			*'''Return precautions:''' Worsening swelling, fever, vision changes, pain with eye movement, inability to open eye

	==See Also==		==See Also==
	*[[Periorbital ~~Swelling~~]]		*[[Periorbital swelling]]
	*[[~~Periorbital vs~~ Orbital ~~Cellulitis]]~~		*[[Orbital cellulitis]]
	*[[Orbital Cellulitis]]

	==References==		==References==
	<references/>		<references/>

	[[Category:ID]]		[[Category:ID]]
	[[Category:Ophthalmology]]		[[Category:Ophthalmology]]
			[[Category:Pediatrics]]

Rossdonaldson1: /* Background */

2026-01-14T21:13:56Z

Background

← Older revision		Revision as of 21:13, 14 January 2026
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	*Rarely leads to orbital cellulitis		*Rarely leads to orbital cellulitis

	~~===Periorbital vs Orbital Cellulitis===~~
	{{Periorbital vs orbital cellulitis}}		{{Periorbital vs orbital cellulitis}}

Rossdonaldson1 at 22:31, 23 October 2024

2024-10-23T22:31:54Z

← Older revision		Revision as of 22:31, 23 October 2024
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	==Background==		==Background==
			[[File:Orbital septum slide - final big gallery.jpeg\|thumb\|Periorbital anatomy.]]
	*Also known as "preseptal cellulitis"		*Also known as "preseptal cellulitis"
	*Most often due to contiguous infection of soft tissues of face and eyelids		*Most often due to contiguous infection of soft tissues of face and eyelids

Rossdonaldson1: /* Background */

2020-09-26T20:51:02Z

Background

← Older revision		Revision as of 20:51, 26 September 2020
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	==Background==		==Background==
	*Also known as [[preseptal cellulitis]]		*Also known as "preseptal cellulitis"
	*Most often due to contiguous infection of soft tissues of face and eyelids		*Most often due to contiguous infection of soft tissues of face and eyelids
	*Most patients are <10yr		*Most patients are <10yr

Rossdonaldson1: /* Background */

2020-09-26T20:50:35Z

Background

← Older revision		Revision as of 20:50, 26 September 2020
Line 1:		Line 1:
	==Background==		==Background==
			*Also known as [[preseptal cellulitis]]
	*Most often due to contiguous infection of soft tissues of face and eyelids		*Most often due to contiguous infection of soft tissues of face and eyelids
	*Most patients are <10yr		*Most patients are <10yr

Rossdonaldson1: /* Clinical Features */

2020-09-26T20:49:14Z

Clinical Features

← Older revision		Revision as of 20:49, 26 September 2020
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	==Clinical Features==		==Clinical Features==
			[[File:PMC3214412 IJO-59-431-g007.png\|thumb\|Periorbital cellulitis]].
	*Swelling, tenderness, and erythema of eyelids and superficial tissues surrounding the orbit		*Swelling, tenderness, and erythema of eyelids and superficial tissues surrounding the orbit
	*+/- [[fever]]		*+/- [[fever]]

ClaireLewis at 21:33, 6 October 2019

2019-10-06T21:33:48Z

← Older revision		Revision as of 21:33, 6 October 2019
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	==Clinical Features==		==Clinical Features==
	*Swelling, tenderness, and erythema of eyelids and superficial tissues surrounding the orbit		*Swelling, tenderness, and erythema of eyelids and superficial tissues surrounding the orbit
	*+/- fever		*+/- [[fever]]
	*Lack of:		*'''Lack of''':
	**Proptosis		**[[Proptosis]]
	**Chemosis		**[[red eye\|Chemosis]]
	**Globe displacement		**Globe displacement
	**Limitation of eye movements		**Limitation of eye movements
	**Pain with eye movement		**Pain with eye movement
	**Double vision		**[[diplopia\|Double vision]]
	**Vision loss (indicates orbital apex involvement)		**[[Vision loss]] (indicates orbital apex involvement)

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Evaluation */

2019-07-20T11:07:39Z

Evaluation

← Older revision		Revision as of 11:07, 20 July 2019
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	==Evaluation==		==Evaluation==
			[[File:RtmaxobitinfectteethCT.png\|thumb\|Periorbital cellulitis caused by a dental infection (also causing maxillary [[sinusitis]]).]]
	*CT Orbit with IV contrast if:		*CT Orbit with IV contrast if:
	**Concern for orbital cellulitis-i.e. equivocal assessment of proptosis, red eye, EOM function or pain w/ eye movement		**Concern for orbital cellulitis-i.e. equivocal assessment of proptosis, red eye, EOM function or pain w/ eye movement

Gheid: /* Evaluation */

2019-06-20T17:58:13Z

Evaluation

← Older revision		Revision as of 17:58, 20 June 2019
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	==Evaluation==		==Evaluation==
	*CT Orbit with IV contrast if:		*CT Orbit with IV contrast if:
	**Concern for orbital cellulitis		**Concern for orbital cellulitis-i.e. equivocal assessment of proptosis, red eye, EOM function or pain w/ eye movement
	**Unable to accurately assess vision (e.g. age <1yr)		**Unable to accurately assess vision (e.g. age <1yr)