Cellulitis
What are orbital cellulitis and pre-septal cellulitis?
These conditions refer to an inflammation and infection of the tissue and
skin that surround the eye. They are serious infections that involve the eye and
the structures around the eye. Pre-septal cellulitis involves the area from the
skin of the eyelid to the bony area that encloses the eye. Orbital cellulitis is
an infection that involves the eye and the eye structures within the bony cavity
of the face. Both of these conditions are serious and require immediate medical
attention by your child's physician.
What causes pre-septal/orbital cellulitis?
The most common cause of these types of cellulitis is from an infection with
bacteria. The following are the bacteria that are usually involved
- Staphylococcus aureus
- Streptococcus pyogenes
- Haemophilus influenzae
The bacteria gets into the eye and the surrounding cavity many different
ways. The two most common ways the infection gets into the eye include the
following:
- Trauma - Direct trauma to the eye can lead to infection
from the bacteria.
- Spread from other areas - Most commonly, the infection
begins in the sinuses. The sinuses are cavities, or air-filled pockets, that
are near the nasal passage.
Symptoms of pre-septal cellulitis:
The following are the most common symptoms of pre-septal cellulitis. However,
each child may experience symptoms differently. Symptoms appear abruptly and may
include:
- Swelling of the upper and lower eyelid
- Redness of the upper and lower eyelid
- Warmth of skin
- Pain
- Fever
- General discomfort of the eye
The eyeball is often not affected and appears normal.
Symptoms of orbital cellulitis:
The following are the most common symptoms of orbital cellulitis. However,
each child may experience symptoms differently. Symptoms appear slowly and may
include:
- Swelling of the upper and lower eyelid
- Orbit becomes swollen and bulges
- Eye may appear red
- Decrease in the child's ability to move the eyeball
- Decrease in vision
- Fever
- General discomfort
The symptoms of pre-septal/orbital cellulitis may resemble other eye
conditions or medical problems. Always consult your child's physician for a
diagnosis.
How are pre-septal/orbital cellulitis diagnosed?
Diagnosis is usually based on a complete medical history and physical
examination of your child. In addition, your child's physician may order the
following tests to help confirm the diagnosis:
- Blood tests
- X-ray
- Computed tomography scan (Also called a CT or CAT scan.) - a diagnostic
imaging procedure that uses a combination of x-rays and computer technology to
produce cross-sectional images (often called slices), both horizontally and
vertically, of the body. A CT scan shows detailed images of any part of the
body, including the bones, muscles, fat, and organs. CT scans are more
detailed than general x-rays. The extent of the infection is detected by
performing a CT scan.
- Cultures of the drainage from the eyes
Treatment of pre-septal and orbital cellulitis
Treatment of pre-septal cellulitis: Specific treatment
for pre-septal cellulitis will be determined by your child's physician based on:
- Your child's age, overall health, and medical history
- The extent of the condition
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Treatment will usually include oral antibiotics. Close follow up with your
child's physician is necessary for constant monitoring.
Treatment of orbital cellulitis: Specific treatment for
orbital cellulitis will be determined by your child's physician based on:
- Your child's age, overall health, and medical history
- The extent of the condition
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Orbital cellulitis is a serious condition and must be treated promptly.
Treatment may include:
- Consultation with an ophthalmologist (eye care specialist)
- Hospitalization — Your child may be admitted to the hospital for
antibiotics through an intravenous (IV) catheter. Hospitalization also allows
for close evaluation of your child and the condition.
- Surgery — Surgical drainage of the sinuses or any abscesses of the eye is
sometimes needed.
What are possible complications from pre-septal and orbital cellulitis?
The risk of complications may be reduced with prompt and accurate treatment
of the problem. The following are some of the more common complications that may
occur:
- Meningitis (an infection of the outside of the brain and the spinal cord)
- Loss of vision
- Brain abscess (with the possibility of permanent neurologic
deficits)