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Infections of the Orbit

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Ocular Infections

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

Abstract

Orbital infection most commonly originates from adjacent paranasal sinuses, but it can result from other local or distant infectious sources. This is a diagnostic and therapeutic emergency that can be subdivided into preseptal infection and postseptal infection, usually called orbital cellulitis. Diagnosis of orbital infection is primarily based on clinical findings, and imaging is very helpful to confirm the diagnosis and to assess the extension of the infectious process. Prompt, proper management of orbital infection is crucial to prevent sight-threatening, as well as life-threatening, complications. This chapter emphasizes the distinctive characteristics of preseptal and orbital cellulitis, with a focus on pathophysiologic mechanisms, diagnosis, and management strategies (Table 3.1).

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References

  1. Som PM, Curtin HD, editors. Head and neck imaging. St Louis: Mosby; 1996. p. 1090–5.

    Google Scholar 

  2. Bagheri A, Tavakoli M, Aletaha M, Salour H, Ghaderpanah M. Orbital and preseptal cellulitis: a 10-year survey of hospitalized patients in a tertiary eye hospital in Iran. Int Ophthalmol. 2012;32(4):361–7.

    Article  PubMed  Google Scholar 

  3. Connell B, Kamal Z, McNab AA. Fulminant orbital cellulitis with complete loss of vision. Clin Exp Ophthalmol. 2001;29:260–1.

    Article  CAS  Google Scholar 

  4. Harris GJ. Subperiosteal abscess of the orbit. Arch Ophthalmol. 1983;101:751–7.

    Article  CAS  PubMed  Google Scholar 

  5. Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80(9):1414–28.

    Article  CAS  PubMed  Google Scholar 

  6. Oxford LE, McClay J. Complications of acute sinusitis in children. Otolaryngol Head Neck Surg. 2005;133(1):32–7.

    Article  PubMed  Google Scholar 

  7. Kikkawa DO, Heinz GW, Martin RT, Nunery WN, Eiseman AS. Orbital cellulitis and abscess secondary to dacryocystitis. Arch Ophthalmol. 2002;120(8):1096–9.

    PubMed  Google Scholar 

  8. Buchanan MA, Muen W, Heinz P. Management of periorbital and orbital cellulitis: review article. Paediatr Child Health. 2012;22(2):72–7.

    Article  Google Scholar 

  9. Lee S, Yen MT. Management of preseptal and orbital cellulitis. Saudi J Ophthalmol. 2011;25:21–9.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Chaudhry IA, Shamsi FA. Outcome of treated orbital cellulitis in a tertiary eye care center in the middle East. Ophthalmology. 2007;114(2):345–54.

    Article  PubMed  Google Scholar 

  11. Sultész M, Csákányi Z, Majoros T, et al. Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006. Int J Pediatr Otorhinolaryngol. 2009;73(11):1507–12.

    Article  PubMed  Google Scholar 

  12. Ho CF, Huang YC, Wang CJ, et al. Clinical analysis of computed tomography-staged orbital cellulitis in children. J Microbiol Immunol Infect. 2007;40(6):518–24.

    PubMed  Google Scholar 

  13. Schmitt NJ, Beatty RL, Kennerdell JS. Superior ophthalmic vein thrombosis in a patient with dacryocystitis-induced orbital cellulitis. Ophthal Plast Reconstr Surg. 2005;21(5):387–9.

    Article  PubMed  Google Scholar 

  14. Maheshwari R, Maheshwari S, Shah T. Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 2009;28(2–3):196–9.

    Article  PubMed  Google Scholar 

  15. Akhaddar A, Elasri F, Elouennass M, et al. Orbital abscess associated with sinusitis from odontogenic origin. Intern Med. 2010;49(5):523–4.

    Article  PubMed  Google Scholar 

  16. Argelicha R, Ibáñez-Floresb N, Bardaviob J, et al. Orbital cellulitis and endogenous endophthalmitis secondary to Proteus mirabilis cholecystitis. Diagn Microbiol Infect Dis. 2009;64(4):442–4.

    Article  Google Scholar 

  17. Armesto A, Ugrin MC. Orbital cellulitis after faden operation on the medial rectus. Strabismus. 2007;15(4):215–9.

    Article  PubMed  Google Scholar 

  18. McLeod SD, Flowers CW, Lopez PF, Marx J, McDonnell PJ. Endophthalmitis and orbital cellulitis after radial keratotomy. Ophthalmology. 1995;102(12):1902–7.

    Article  CAS  PubMed  Google Scholar 

  19. Hofbauer JD, Gordon LK, Palmer J. Acute orbital cellulitis after peribulbar injection. Am J Ophthalmol. 1994;118(3):391–2.

    Article  CAS  PubMed  Google Scholar 

  20. Cox NH, Knowles MA, Porteus ID. Pre-septal cellulitis and facial erysipelas due to Moraxella species. Clin Exp Dermatol. 1994;19(4):321–3.

    Article  CAS  PubMed  Google Scholar 

  21. Molarte AB, Isenberg SJ. Periorbital cellulitis in infancy. J Pediatr Ophthalmol Strabismus. 1989;26(5):232–4.

    CAS  PubMed  Google Scholar 

  22. Smith TF, O’Day D, Wright PF. Clinical implications of preseptal (periorbital) cellulitis in childhood. Pediatrics. 1978;62(6):1006–9.

    CAS  PubMed  Google Scholar 

  23. Rumelt S, Rubin PA. Potential sources for orbital cellulitis. Int Ophthalmol Clin. 1996;36(3):207–21.

    Article  CAS  PubMed  Google Scholar 

  24. Howe L, Jones NS. Guidelines for the management of periorbital cellulitis/abscess. Clin Otolaryngol. 2004;29(6):725–8.

    Article  CAS  PubMed  Google Scholar 

  25. Jones DB, Steinkuller PG. Strategies for the initial management of acute preseptal and orbital cellulitis. Trans Am Ophthalmol Soc. 1988;86:94–108.

    CAS  PubMed Central  PubMed  Google Scholar 

  26. Lessner A, Stern GA. Preseptal and orbital cellulitis. Infect Dis Clin North Am. 1992;6(4):933–52.

    CAS  PubMed  Google Scholar 

  27. Yeh CH, Chen WC, Lin MS, Huang HT, Chao SC, Lo YC. Intracranial brain abscess preceded by orbital cellulitis and sinusitis. J Craniofac Surg. 2010;21(3):934–6.

    Article  PubMed  Google Scholar 

  28. Ferguson MP, McNab AA. Current treatment and outcome in orbital cellulitis. Aust N Z J Ophthalmol. 1999;27(6):375–9.

    Article  CAS  PubMed  Google Scholar 

  29. Weiss A, Friendly D, Eglin K, Chang M, Gold B. Bacterial periorbital and orbital cellulitis in childhood. Ophthalmology. 1983;90(3):195–203.

    Article  CAS  PubMed  Google Scholar 

  30. Robinson A, Beech T, McDermott AL, Sinha A. Investigation and management of adult periorbital and orbital cellulitis. J Laryngol Otol. 2007;121(6):545–7.

    Article  CAS  PubMed  Google Scholar 

  31. Uzcátegui N, Warman R, Smith A, Howard CW. Clinical practice guidelines for the management of orbital cellulitis. J Pediatr Ophthalmol Strabismus. 1998;35(2):73–9.

    PubMed  Google Scholar 

  32. McKinley SH, Yen MT, Miller AM, Yen KG. Microbiology of pediatric orbital cellulitis. Am J Ophthalmol. 2007;144(4):497–501.

    Article  PubMed  Google Scholar 

  33. Seltz LB, Smith J, Durairaj VD, Enzenauer R, Todd J. Microbiology and antibiotic management of orbital cellulitis. Pediatrics. 2011;127(3):566–72.

    Article  Google Scholar 

  34. Fanella S, Singer A, Embree J. Presentation and management of pediatric orbital cellulitis. Can J Infect Dis Med Microbiol. 2011;22(3):97–100.

    PubMed Central  PubMed  Google Scholar 

  35. Ambati BK, Ambati J, Azar N, Stratton L, Schmidt EV. Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination. Ophthalmology. 2000;107(8):1450–3.

    Article  CAS  PubMed  Google Scholar 

  36. Patt BS, Manning SC. Blindness resulting from orbital complications of sinusitis. Otolaryngol Head Neck Surg. 1991;104(6):789–95.

    CAS  PubMed  Google Scholar 

  37. Suneetha N, Battu RR, Thomas RK, Bosco A. Orbital abscess: management and outcome. Indian J Ophthalmol. 2000;48(2):129–34.

    CAS  PubMed  Google Scholar 

  38. Toumi A, Larbi Ammari F, Loussaief C, Hadhri R, Ben Brahim H, Harrathi K, Ben Romdhane F, Koubaa J, Chakroun M. Rhino-orbito-cerebral mucormycosis: five cases. Med Mal Infect. 2012;42(12):591–8.

    Article  CAS  PubMed  Google Scholar 

  39. O’Ryan F, Diloreto D, Barber HD, Bruckner R. Orbital infections: clinical and radiographic diagnosis and surgical treatment. J Oral Maxillofac Surg. 1988;46(11):991–7.

    Article  PubMed  Google Scholar 

  40. Hornblass A, Herschorn BJ, Stern K, Grimes C. Orbital abscess. Surv Ophthalmol. 1984;29(3):169–78.

    Article  CAS  PubMed  Google Scholar 

  41. Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology. 1994;101(3):585–95.

    Article  CAS  PubMed  Google Scholar 

  42. Harris GJ. Subperiosteal abscess of the orbit: computed tomography and the clinical course. Ophthal Plast Reconstr Surg. 1996;12(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  43. Harris GJ. Subperiosteal abscess of the orbit: older children and adults require aggressive treatment. Ophthal Plast Reconstr Surg. 2001;17(6):395–7.

    Article  CAS  PubMed  Google Scholar 

  44. Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases. A retrospective review of 262 cases. Int J Pediatr Otorhinolaryngol. 2008;72(3):377–83.

    Article  CAS  PubMed  Google Scholar 

  45. Bedwell J, Bauman NM. Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg. 2011;19(6):467–73.

    Article  PubMed  Google Scholar 

  46. Yang M, Quah BL, Seah LL, Looi A. Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 2009;28(2–3):124–36.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Moncef Khairallah MD & Sonia Attia MD

  2. Faculty of Medicine, University of Monastir, Monastir, Tunisia

    Moncef Khairallah MD & Sonia Attia MD

Authors
  1. Moncef Khairallah MD
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  2. Sonia Attia MD
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Corresponding author

Correspondence to Moncef Khairallah MD .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology, The Eye Center, Riyadh, Saudi Arabia

    Khalid F. Tabbara

  2. Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Saudi Arabia

    Ahmed M. Abu El-Asrar

  3. Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Moncef Khairallah

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© 2014 Springer-Verlag Berlin Heidelberg

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Khairallah, M., Attia, S. (2014). Infections of the Orbit. In: Tabbara, K., El-Asrar, A., Khairallah, M. (eds) Ocular Infections. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43981-4_3

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  • DOI: https://doi.org/10.1007/978-3-662-43981-4_3

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-43980-7

  • Online ISBN: 978-3-662-43981-4

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