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Diagnosis and Treatment of Bacterial Infections of the Orbit

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Emergencies of the Orbit and Adnexa

Abstract

Preseptal and orbital cellulitis, both more common in the pediatric population, are important bacterial infections of the orbit. Preseptal cellulitis refers to infection anterior to the orbital septum, while orbital cellulitis describes an infection involving the soft tissues posterior to the orbital septum, involving the soft tissue and muscle in the confined bony orbit. It is important to differentiate these two entities as early diagnosis, aggressive medical treatment, and timely surgical intervention are important to avoid irreversible visual loss and intracranial spread in the case of orbital cellulitis. Periorbital necrotizing fasciitis, though rare, progresses rapidly and is associated with significant morbidity and mortality. Clinicians should be aware of characteristic features and act promptly to save life and vision.

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References

  1. Chandler JR, Langenbrunner DJ, Steven ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80:1414–28.

    Article  CAS  PubMed  Google Scholar 

  2. Chaudhry IA, Shamsi FA, Elzaridi E, et al. 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 

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

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  5. Israele V, Nelson JD. Periorbital and orbital cellulitis. Pediatr Infect Dis J. 1987;6:404–10.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  7. Uzcategui N, Warman R. Clinical practice guidelines for the management of orbital cellulitis. J Pediatr Ophthalmol Strab. 1998;35(2):73–9.

    CAS  Google Scholar 

  8. Donahue SP, Schwartz G. Preseptal and orbital cellulitis in childhood. A changing microbiologic spectrum. Ophthalmology. 1998;105(10):1902–5.

    Article  CAS  PubMed  Google Scholar 

  9. Ambati BK, Ambati J. 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 

  10. 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 

  11. Mortimore S, Wormald PJ. The Groote Schuur hospital classification of the orbital complications of sinusitis. J LaryngolOtol. 1997;111(8):719–23.

    CAS  Google Scholar 

  12. Schmitt NJ, Beatty RL, et al. Superior ophthalmic vein thrombosis in a patient with dacryocystitis-induced orbital cellulitis. Ophthal Plast Reconstr Surg. 2005;21:387–9.

    Article  PubMed  Google Scholar 

  13. Yeh CH, Chen WC, et al. Intracranial brain abscess preceded by orbital cellulitis and sinusitis. J Craniofac Surg. 2010;21(3):934–6.

    Article  PubMed  Google Scholar 

  14. Cox NH, Knowles MA, et al. Pre-septal cellulitis and facial erysipelas due to Moraxella species. Clin Exp Dermatol. 1994;19:321–3.

    Article  CAS  PubMed  Google Scholar 

  15. Kikkawa DO, Heinz GW, et al. Orbital cellulitis and abscess secondary to dacryocystitis. Arch Ophthalmol. 2002;120(8):1096–9.

    PubMed  Google Scholar 

  16. Molarte AB, Isenberg SJ. Periorbital cellulitis in infancy. J Pediatr Ophthalmol Strab. 1989;26:232–4.

    CAS  Google Scholar 

  17. Allen MV, Cohen KL, et al. Orbital cellulitis secondary to dacryocystitis following blepharoplasty. Ann Ophthalmol. 1985;17(8):498–9.

    CAS  PubMed  Google Scholar 

  18. Weakley DR. Orbital cellulitis complicating strabismus surgery: a case report and review of the literature. Ann Ophthalmol. 1991;23(12):454–7.

    CAS  PubMed  Google Scholar 

  19. Lopez PF, Marx J, et al. Endophthalmitis and orbital cellulitis after radial keratotomy. Ophthalmology. 1995;102(12):1902–7.

    Article  PubMed  Google Scholar 

  20. Hofbauer JD, Gordon LK, et al. Acute orbital cellulitis after peribulbar injection. Am J Ophthalmol. 1994;118:391.

    Article  CAS  PubMed  Google Scholar 

  21. Walinjkar J, Krishnakumar S, Gopal L, Ramesh A, Khetan V. Retinoblastoma presenting with orbital cellulitis. J AAPOS. 2013;17(3):282–6.

    Article  PubMed  Google Scholar 

  22. Proctor CM, Magrath GN, de Castro LE, Johnson JH, Teed RG. Orbital cellulitis complicated by central retinal artery occlusion. OphthalPlastReconstr Surg. 2013;29(2):e59–61.

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  24. 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  PubMed Central  Google Scholar 

  25. Brown CL, Graham SM. Nasal irrigations: good or bad? Curr Opin Otolaryngol Head Neck Surg. 2004;12:9–13.

    Article  PubMed  Google Scholar 

  26. Mygind N. Effects of corticosteroid therapy in non-allergic rhinosinusitis. Acta Otolaryngol. 1996;116:164–6.

    Article  CAS  PubMed  Google Scholar 

  27. Yen MT, Yen KG. Effect of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess. OphthalPlastReconstr Surg. 2005;21(5):363–6.

    Google Scholar 

  28. Pushker N, Tejwani LK, Bajaj MS, Khurana S, Velpandian T, Chandra M. Role of oral corticosteroids in orbital cellulitis. Am J Ophthalmol. 2013;156(1):178–83.

    Article  CAS  PubMed  Google Scholar 

  29. Garcia GH, Harris GJ. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988–1998. Ophthalmology. 2000;107(8):1454–6.

    Article  CAS  PubMed  Google Scholar 

  30. Lazzeri D, Lazzeri S, Figus M, Tascini C, Bocci G, Colizzi L, Giannotti G, Lorenzetti F, Gandini D, Danesi R, Menichetti F, Del Tacca M, Nardi M, Pantaloni M. Periorbital necrotising fasciitis. Br J Ophthalmol. 2010;94(12):1577–85.

    Article  PubMed  Google Scholar 

  31. Amrith S, HosdurgaPai V, Wong W. Periorbital necrotizing fasciitis; a review. Acta Ophthalmol. 2013;91(7):596–603.

    Article  PubMed  Google Scholar 

  32. Seal DV. Necrotizing fasciitis. Curr Opin Infect Dis. 2001;14(2):127–32.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Emmy Yuen-mei Li MBBS,MPH, FRCS, FCOphthHK, FHKAM .

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Li, E.Ym., Yuen, H.KL. (2017). Diagnosis and Treatment of Bacterial Infections of the Orbit. In: Mukherjee, B., Yuen, H. (eds) Emergencies of the Orbit and Adnexa. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1807-4_33

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  • DOI: https://doi.org/10.1007/978-81-322-1807-4_33

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  • Publisher Name: Springer, New Delhi

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  • Online ISBN: 978-81-322-1807-4

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