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| Quick reference medical handouts used
by Pediatric offices |
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What is Periorbital cellulitis?
What is periorbital cellulitis?
Cellulitis is an infection of the skin and underlying tissues that can affect
any area of the body. Cellulitis begins in an area of broken skin, like a cut or
scratch, allowing bacteria to invade and spread, causing inflammation, which
includes pain, swelling, warmth, and redness. One specific type of cellulitis
that can occur in children and requires close monitoring is periorbital
cellulitis, an infection of the eyelid and tissues surrounding the eye. It can
be the result of minor trauma to the area around the eye (such as an insect bite
or a scratch), or it may be the extension of another site of infection, such as
sinusitis. Periorbital cellulitis is a serious medical condition and requires immediate
medical attention by your child's physician.
What causes peri-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 bacterium 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.
What are the symptoms of periorbital
cellulitis?
The following are the most common symptoms of periorbital 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
- decrease in the child's ability to move the
eyeball
- decrease in vision
- fever
- general discomfort of the eye
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 - a diagnostic test that uses
invisible electromagnetic energy beams to produce images of internal
tissues, bones, and organs onto film.
- 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 or
the blood
Treatment of periorbital cellulitis:
Orbital cellulitis is a serious condition and must
be treated promptly. Treatment may include:
- consultation with an ophthalmologist (eye
care specialist)
- antibiotics
In its early stages, periorbital cellulitis can be treated with oral
antibiotics. Your child's doctor will probably want to follow your
youngsters progress closely to make sure the drugs are working. But be sure
to complete the entire course of antibiotics, even if his symptoms start
going away, or the infection could resurface
- 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 periorbital
cellulitis?
In rare cases, untreated periorbital cellulitis can progress into orbital
cellulitis, a serious eye condition that involves the eye itself and the
structures within the orbit (the "eye cavity" or "socket").
This condition may affect your child's vision and ability to move his eyeball,
and it usually causes the eye to bulge and sometimes even to swell shut. Orbital
cellulitis requires immediate care — usually, imaging by CT scan or MRI and a
hospital stay, so that antibiotics can be given intravenously. In some cases,
surgery is necessary so that the sinuses, for example, can be drained.
In extremely rare cases, untreated orbital
cellulitis can cause permanent vision problems, meningitis, or neurological
problems in children. But if you follow through with treatment as prescribed and
keep your follow-up appointments, this is highly unlikely. As with any illness,
your best defense as a parent is to play it safe and call your doctor whenever
you're concerned about your child's symptoms.
Summary
Periorbital cellulitis is a serious eye
condition that requires immediate treatment. If your child is complaining of eye
pain and his upper and lower eyelids are red and swollen, call your doctor right
away. (Your child may also have a fever.) If not diagnosed and treated early
this condition can cause long-term vision problems and possibly even more
serious health problems
posted 05-12-04 on kidsgrowth.com
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your child’s pediatrician.
Please read our full disclaimer.
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