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Welcome, medical contents search April 29, 2013
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Orbital Cellulitis

more about Orbital Cellulitis

  • Bacterial infections that affect the orbit and the structures surrounding the eyes
  • Because of the close proximity of the eye to the brain, orbital infections can be very dangerous.

  • Fever
  • Redness or swollen eyelids and eyes.
  • A droop in the eyelids.
  • Pain around the eye and upon eye movement
  • Eyes may bulge forward
  • Headaches
  • Conjunctiva (the lining of the eye lids and the eye surface) may become red and begin to itch.
  • In severe cases, there may be a full or partial loss of vision (Optic neuritis).
  • Neck stiffness and pain, nausea, vomiting, delirium, and coma can occur with spread of infection to the brain.

  • Infection can spread from the paranasal sinuses (air-filled cavities around the eyes), blood, teeth, or other sites in the body, to the tissues immediately surrounding the eyes.
  • Infection can also occur after eye injury.
  • The most common infections are due to bacteria

    1. Staphylococcus aureus
    2. Streptococcus pyogenes and Streptococcus pneumoniae
    3. Mixed infections with different bacteria can also occur

  • In children under the age of 5, H. influenzae is the most common bacterium.  Recent vaccinations with the HB vaccine are showing a drop in the number of cases.
  • Fungi are seen in those with a weak immune or body defense system.

  • Examination of the body and the eye to check for structure and vision.
  • Samples of the nasal (nose) or conjunctival drainage may be collected using a sterile cotton swab, then sent for cultures where bacteria are grown and properly identified.  This may take 2-3 days.
  • Blood may be taken and sent to a laboratory analysis, which provides information about the severity and source of the infection.
  • Blood tests include a complete count of white and red blood cells (CBC) and blood cultures.
  • Antistreptolysin O and other antibodies (proteins) in the blood can tell the physician which type of Streptococcus is the cause for the infection.
  • Radiographs (X-Rays) can show the infection in the sinuses and bones around the eye
  • CAT scans and MRIs are able to show a more detailed picture of the sinuses and the eye.

  • Recent sinus infections
  • Long term untreated sinus infections
  • Dental infections
  • Blood or brain infections (meningitis)
  • Surgeries -- dental, sinus, or eye
  • Disconjugate gaze (failure of the eyes to move together)
  • Trauma or puncture wound to the eye
  • Malnutrition
  • Diseases that weaken the body's defenses such as AIDS or diabetes

  • Mild cases are treated with antibiotics at home
  • For severe cases, antibiotics such as Nafcillin, ampicillin, or ceftaxime are given intravenously (IV), and require multiple dosages.
  • The IV is given in the hospital. After 7-10 days, if the patient is doing better, oral forms of the antibiotics can be started.
  • If there is Influenza or cellulitis, an antibiotic called Rifampin should be given to the entire family for prevention.
  • If an abscess develops, surgical drainage may be needed.
  • Surgical drainage of the infected site is also needed if there is no improvement in symptoms with antibiotics in 24-48 hours, or the patient's vision is getting worse.
  • Food can be taken immediately.

  • Have your child avoid swimming if he/she has a skin cut or abrasion.  Good hygiene is important, so wash the infected area with soap.  Arrange for a visit to the pediatrician as soon as possible, especially if he/she has another illness (e.g., cancer, diabetes), and taking potent medications such as anti-cancer drugs or insulin.

  • An abscess or infection behind the eye
  • Multiple sclerosis

more about Orbital Cellulitis

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