Periorbital cellulitis

Background

  • Most often due to contiguous infection of soft tissues of face and eyelids
  • Most patients are <10yr
  • Rarely leads to orbital cellulitis

Periorbital vs Orbital Cellulitis

Clinical Features

  • Swelling, tenderness, and erythema of eyelids and superficial tissues surrounding the orbit
  • +/- fever
  • Lack of:

Differential Diagnosis

Periorbital swelling

Proptosis

No proptosis

Lid Complications

Other

Evaluation

Periorbital cellulitis caused by a dental infection (also causing maxillary sinusitis).
  • CT Orbit with IV contrast if:
    • Concern for orbital cellulitis-i.e. equivocal assessment of proptosis, red eye, EOM function or pain w/ eye movement
    • Unable to accurately assess vision (e.g. age <1yr)

Management

Antibiotics

Outpatient

Inpatient

Vancomycin 15-20mg/kg IV BID + (one of the following)

Disposition

  • If well-appearing and afebrile consider discharge

See Also

References