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Preseptal Cellulitis

Periorbital %2F Preseptal Cellulitis


Presentation

  • Orbital cellulitis: eyelid edema and erythema, diminished visual acuity, proptosis is present, relative afferent pupillary defect may be present, reduced color saturation, chemotic conjunctiva and reduced extraocular movements with pain elicited by these[eyewiki.org]
  • Patients present with unilateral eyelid swelling and edema. Those with orbital cellulitis present with similar findings plus ocular symptoms such as proptosis, eye pain, decreased vision, limited extraocular motility.[ncbi.nlm.nih.gov]
  • Introduction Infections of the eye occur in the pediatric population and may present with complaints of eyelid swelling and pain.[pedsinreview.aappublications.org]
  • Patients in the non-insect bite group more commonly had fever at presentation (p Biography : Nadav Friedel has completed his MD at Semmelweis University, Budapest, Hungary in 2011.[longdom.org]
  • If any of these features is present, one must assume that the patient has orbital cellulitis and begin treatment with IV antibiotics. CT scan may be done to delineate the extension of the infection.[en.wikipedia.org]
Physician
  • These patients should be treated by a multidisciplinary team: ophthalmologist, pediatrician/primary care physician and ENT (in case of an associated sinusitis).[eyewiki.org]
  • […] clinician is unsure if a patient has periorbital or orbital cellulitis even with a CT scan, it is recommended to treat as orbital cellulitis. [9] [10] Enhancing Healthcare Team Outcomes Anytime a patient has an eye infection, the emergency department physician[ncbi.nlm.nih.gov]
Pneumonia
  • Streptococcus pneumoniae is a common etiology in preseptal cellulitis secondary to sinusitis.[eyewiki.org]
  • Typical signs include periorbital erythema, induration, tenderness and warmth. [2] Causes [ edit ] Staphylococcus aureus, Streptococcus pneumoniae, other streptococci, and anaerobes are the most common causes, depending on the origin of the infection.[en.wikipedia.org]
  • Pathophysiology The most common bacterial causes of periorbital cellulitis are Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes.[ncbi.nlm.nih.gov]
Skin Discoloration
  • It presents as a rapidly progressive cellulitis with poorly demarcated borders and violaceous skin discoloration, which can lead to necrosis and toxic shock syndrome.[eyewiki.org]
Lacrimation
  • Orbit, Eyelids, and Lacrimal System, Section 7. Basic and Clinical Science Course 2011-2012. American Academy of Ophthalmology. San Francisco, CA. 2011. Uddin JM, Scawn RL. Chapter 13: Preseptal and orbital cellulitis. Hoyt CS and Taylor D.[eyewiki.org]
Meningism
  • Central nervous system involvement (after orbital extension): meningitis, abscesses (brain, extradural or subdural). Necrotizing fasciitis: it is a rare complication caused by β-hemolytic Streptococcus.[eyewiki.org]
  • In very severe cases, patients may have meningitis. Although not always a true continuum, the conditions in this classification system present similarly and must be considered during the evaluation of a patient with ophthalmic complaints.[ncbi.nlm.nih.gov]

Workup

Staphylococcus Aureus
  • Staphylococcus aureus and epidermidis are commonly found after a penetrating eyelid trauma. Streptococcus pneumoniae is a common etiology in preseptal cellulitis secondary to sinusitis.[eyewiki.org]
  • Typical signs include periorbital erythema, induration, tenderness and warmth. [2] Causes [ edit ] Staphylococcus aureus, Streptococcus pneumoniae, other streptococci, and anaerobes are the most common causes, depending on the origin of the infection.[en.wikipedia.org]
  • However, there are now increasing instances of methicillin-resistant Staphylococcus aureus (MRSA) causing periorbital cellulitis.[ncbi.nlm.nih.gov]
Streptococcus Pneumoniae
  • Streptococcus pneumoniae is a common etiology in preseptal cellulitis secondary to sinusitis.[eyewiki.org]
  • Typical signs include periorbital erythema, induration, tenderness and warmth. [2] Causes [ edit ] Staphylococcus aureus, Streptococcus pneumoniae, other streptococci, and anaerobes are the most common causes, depending on the origin of the infection.[en.wikipedia.org]
  • Pathophysiology The most common bacterial causes of periorbital cellulitis are Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes.[ncbi.nlm.nih.gov]
Gram-Positive Bacteria
  • You can help by adding to it. ( February 2019 ) Treatment [ edit ] Antibiotics are aimed at gram positive bacteria. Medical attention should be sought if symptoms persist beyond 2–3 days.[en.wikipedia.org]

Treatment

  • If the condition improves, treatment can be switched to the appropriate oral antibiotics based on cultures.[eyewiki.org]
  • Treatment / Management The treatment of periorbital cellulitis differs based on the severity of disease and age of the patient. The mainstay of treatment is usually antibiotic coverage against S. aureus, the Streptococcus species, and anaerobes.[ncbi.nlm.nih.gov]
  • Treatment Antibiotics are given by mouth, by shots, or through a vein (intravenously; IV) to help fight the infection.[account.allinahealth.org]
  • You can help by adding to it. ( February 2019 ) Treatment [ edit ] Antibiotics are aimed at gram positive bacteria. Medical attention should be sought if symptoms persist beyond 2–3 days.[en.wikipedia.org]

Prognosis

  • Prognosis is usually good when this entity is promptly diagnosed and treated. However, complications can develop even with prompt treatment.[eyewiki.org]
  • Tests that may be ordered include: Blood culture Blood tests (complete blood count) CT scan MRI scan Outlook (Prognosis) Periorbital cellulitis almost always improves with treatment.[account.allinahealth.org]

Etiology

  • In the immunocompromised patient we must suspect fungi as a possible etiology.[eyewiki.org]
  • […] that initiates the cellulitis 2,3 and others implying a direct causation. 1,4 The most frequently encountered pathogens have been Haemophilus influenzae in those patients with an upper respiratory tract infection; staphylococci and streptococci are etiologic[jamanetwork.com]
  • Most conditions of periorbital cellulitis resolve after five to seven days with proper antibiotics. [1] [2] [3] [4] Etiology Periorbital cellulitis is commonly caused by the spread of infection of rhinosinusitis or infection after a local trauma; therefore[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology Periorbital cellulitis can occur at any age, but it is especially common in the pediatric population. Periorbital cellulitis is more common than orbital cellulitis.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Describe the cause, pathophysiology, and management of periorbital and orbital cellulitis. Understand the importance of sinus disease in both periorbital and orbital cellulitis.[pedsinreview.aappublications.org]
  • Pathophysiology The most common bacterial causes of periorbital cellulitis are Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes.[ncbi.nlm.nih.gov]

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