Facial and periorbital cellulitis with orbital involvement

Abstract

Orbital cellulitis is a rare, serious and potentially fatal condition, usually associated with trauma to the eyelids, external ocular infection, upper respiratory tract infection and, especially, sinusitis. It is distinct from the more common periorbital cellulitis because it involves all contents of the orbit and may threaten both the vision and the life of the patient. It occurs with greater frequency in children. We report the case of a 34-year-old woman with severe facial and right periorbital cellulitis who rapidly developed orbital involvement, as shown by computed tomography. Apart from a bilateral retroauricular dermatitis, present for several years, the woman had been always healthy. Systemic antibiotics were started without delay and she recovered very well, with no ocular sequelae. This case illustrates that a subset of bacterial skin infections is becoming more aggressive and should be recognized and treated early.

Haemophilus influenzae periorbital cellulitis in a 95-year-old patient

“…POC occurs almost exclusively in children 1-7,9,12-15 and is more frequent in males than in females 13,14 . Cases in adults are extremely rare 8,10,11 . Important predisposing factors of POC are local trauma 3,4,12,13 .…”

“…Differential diagnosis includes orbital cellulitis, a severe infection involving the contents of the orbit, and herpes zoster. Therapy is based on systemic antibiotics, selected according the results of antibiogram, and incision and drainage 10 .…”

El lado oscuro de la sinusitis

“…Las celulitis orbitarias y periorbitarias son usualmente secundarias a trauma, infecciones oculares e infecciones del tracto respiratorio superior, principalmente la sinusitis en la cual se ha encontrado asociación en 70% a 80% de los casos (1). Su presentación es mayor en los niños y adolescentes, en los adultos es rara y más aun presentaciones tan agresivas y de evolución acelerada como el caso en discusión.…”

Managment of orbital complications of sinusitis

“…Other suggested initial intravenous antibiotics for orbital cellulitis are ampicillin (25) , cefuroxime (16) , ampicillin and nafcillin (26) , ampicillin and methicillin (25) , ampicillin and chloramphenicol (11) , vancomycin and chloramphenicol (15) , cloxacillin and chloramphenicol (15) , or imipenem and vancomycin (27) . Multiple antibiotics were used in 72.5% of our patients and the most common combination was ceftriaxone and metronidazole.…”