Summary about Disease
Orbital cellulitis is an infection of the tissues around the eye. It's a serious condition that can cause pain, swelling, and vision problems. It typically affects the soft tissues of the orbit (the bony cavity surrounding the eyeball), but does not involve the eyeball itself. It's most common in children, but can occur in adults. If left untreated, it can lead to severe complications, including vision loss, brain infection, and even death.
Symptoms
Symptoms of orbital cellulitis can include:
Swelling and redness of the eyelids and surrounding skin
Eye pain, especially with movement
Bulging of the eye (proptosis)
Difficulty moving the eye
Double vision or decreased vision
Fever
Headache
General feeling of being unwell (malaise)
Inability to open the eye
Causes
Orbital cellulitis is usually caused by a bacterial infection that spreads from nearby sinuses (sinusitis is the most common cause), skin infections, dental infections, or through direct trauma to the eye socket. The most common bacteria involved include Staphylococcus aureus, *Streptococcus pneumoniae*, and other streptococcal species. Less common causes include fungal infections.
Medicine Used
4. Medicine used The primary treatment for orbital cellulitis is intravenous (IV) antibiotics. Common antibiotics used include:
Vancomycin
Ceftriaxone
Cefotaxime
Piperacillin-tazobactam
Clindamycin The specific antibiotic used will depend on the suspected or confirmed bacteria causing the infection and the patient's overall health and allergies. Pain medication is often prescribed for comfort. In some cases, surgery may be necessary to drain an abscess or decompress the orbit.
Is Communicable
Orbital cellulitis itself is not directly communicable from person to person. However, the underlying infection, such as a sinus infection or skin infection, that led to the orbital cellulitis *may* be communicable.
Precautions
Precautions depend on the underlying cause. If the orbital cellulitis is secondary to a communicable infection like a respiratory infection (e.g., caused by streptococcus), standard hygiene practices such as handwashing, covering coughs and sneezes, and avoiding close contact with others are important to prevent spread. However, orbital cellulitis itself doesn't require isolation beyond addressing the underlying cause if it's communicable. General wound care is important for any skin infection. Timely treatment of sinusitis or other infections can reduce the risk of orbital cellulitis.
How long does an outbreak last?
With prompt and appropriate antibiotic treatment, improvement is usually seen within 24-48 hours. The full course of IV antibiotics typically lasts 1-2 weeks, followed by oral antibiotics for an additional period, depending on the severity and response to treatment. Without treatment, orbital cellulitis can rapidly worsen and lead to serious complications.
How is it diagnosed?
Diagnosis of orbital cellulitis typically involves:
Physical Examination: Assessing the signs and symptoms, including swelling, redness, eye movement, and vision.
Complete Blood Count (CBC): To check for signs of infection.
Blood Cultures: To identify the bacteria causing the infection.
Imaging Studies: CT scan of the orbits and sinuses is the most important diagnostic tool to assess the extent of the infection, rule out an abscess, and identify the source (e.g., sinusitis). MRI may be used in some cases.
Timeline of Symptoms
The timeline of symptoms can vary, but generally:
Early: Initial symptoms may resemble a mild eye infection with redness and swelling of the eyelid. There may be mild pain.
Progressive: Over 24-48 hours, the swelling and redness worsen. Pain increases, especially with eye movement. Fever, headache, and malaise may develop.
Severe: If untreated, proptosis (bulging of the eye), limited eye movement, vision changes (double vision or decreased vision), and signs of systemic illness become more prominent. It's crucial to seek medical attention immediately if symptoms develop, as rapid progression is possible.
Important Considerations
Prompt Treatment is Crucial: Orbital cellulitis is a medical emergency and requires immediate treatment to prevent serious complications.
Differential Diagnosis: It's important to differentiate orbital cellulitis from preseptal cellulitis (infection of the eyelid without orbital involvement), which is less severe.
Monitoring: Close monitoring of vision, eye movement, and overall condition is essential during treatment.
Complications: Potential complications include vision loss, cavernous sinus thrombosis, meningitis, brain abscess, and sepsis.
Surgical Intervention: May be required if there's an abscess or if the infection doesn't respond to antibiotics.
Follow-up: After treatment, follow-up appointments are necessary to ensure complete resolution of the infection and to monitor for any long-term complications.