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Orbital Cellulitis

more about Orbital Cellulitis

  • Infections that affect 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 Comas can occur with spread of infection to the brain

  • Infections 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.
  • Infections can also occur after eye trauma.
  • The most common infections are due to bacteria
  • Staphylococcus aureus is the most common cause in adults.
  • Streptococcus pyogenes and Pneumonia
  • Mixed infections with different bacteria can also occur
  • In children under the age of 5, H. influenzae is the most common bacteria.  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 for analyses, 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 bacteria 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
  • Trauma or puncture wound to the eye
  • Malnutrition
  • Diseases that weaken 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 Cefotaxime 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 cellulites, 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.

  • Avoid swimming if you have a skin cut or abrasion.  Good hygiene is important, so wash the infected area with soap.  Arrange to see your doctor as soon as possible, especially if you have another illness (diabetes), and are taking potent drugs (heroin, cocaine, crack, etc.) or medications such as anti-cancer drugs.

more about Orbital Cellulitis

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