Journal of the Chinese Medical Association
Volume 69, Issue 9 , Pages 415-422, September 2006

Preseptal and Orbital Cellulitis: A 10-Year Review of Hospitalized Patients

Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 30 December 2005; accepted 4 July 2006.

Article Outline

Background

Preseptal and orbital cellulitis range in severity from minor to potentially severe complications. The purpose of this study is to describe the clinical features of patients with preseptal or orbital cellulitis in one medical center in Taiwan, and to assess the effectiveness of treatments and the complications.

Methods

Patients admitted between 1996 and 2005 to Taipei Veterans General Hospital under the diagnosis of preseptal or orbital cellulitis were retrospectively reviewed. The demographics, administrative history, past history, clinical presentations, treatments, and complications were analyzed.

Results

In total, 94 patients fulfilling the diagnostic criteria for preseptal or orbital cellulitis were identified (67 had pre-septal cellulitis, 27 had orbital cellulitis). While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesions in children and dacryocystitis in adults were the most common in preseptal cases. Microbiologic investigations showed variable results, but the most common pathogen isolated was Staphylococcus aureus. Cultures from eye swabs and local abscesses gave the highest positive yield. Blood cultures were taken in some patients, but the positive rate was extremely low. Treatments included intravenous antibiotics alone, or intravenous antibiotics combined with surgical drainage. Only one case had permanent ocular motility impairment after removal of the orbital foreign body.

Conclusion

Despite the past history of potential morbidity and even mortality from orbital cellulitis, early diagnosis and prompt treatment with proper antibiotics and/or surgical intervention can achieve a good prognosis.

Key Words:  cellulitis , orbital , preseptal

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References 

  1. Swift AC , Charlton G . Sinusitis and the acute orbit in children . J Laryngol Otol . 1990;104:213–216
  2. Moloney JR , Badham NJ , McRae A . The acute orbit: preseptal (periorbital) cellulitis, subperiosteal abscess and orbital celluli-tis due to sinusitis . J Laryngol Otol Suppl . 1987;12:1–18
  3. Wagenmann M , Nacleiro RM . Complications of sinusitis . J Allergy Clin Immunol . 1992;90:552–554
  4. Davis JP , Stearns MP . Orbital complications of sinusitis: avoid delays in diagnosis . Postgrad Med J . 1994;70:108–110
  5. Wald ER , Pang D , Milmoe GJ , Schramm VL . Sinusitis and its complications in paediatric patients . Paediatr Clin North Am . 1981;28:777–796
  6. Jain A , Rubin PA . Orbital cellulitis in children . Int Ophthalmol Clin . 2001;41:71–86
  7. Hodges E , Tabbara KF . Orbital cellulitis: review of 23 cases from Saudi Arabia . Br J Ophthalmol . 1989;73:205–208
  8. Connell B , Kamal Z , McNab AA . Fulminant orbital cellulitis with complete loss of vision . Clin Exp Ophthalmol . 2001;29:260–261
  9. Jackson K , Baker SR . Periorbital cellulitis . Head Neck Surg . 1987;9:227–234
  10. Jakobiec FA , Bilyk JR , Font RL . Orbit . In:  Spencer WH editors. 4th edition. Ophthalmic Pathology . 4: Philadelphia: WB Saunders; 1990;p. 2861–2872
  11. Ferguson MP , McNab AA . Current treatment and outcome in orbital cellulitis . Aust N Z J Ophthalmol . 1999;27:375–379
  12. Israele V , Nelson JD . Periorbital and orbital cellulitis . Pediatr Infect Dis J . 1987;6:404–410
  13. Seah LL , Fu ER . Acute orbital cellulitis: a review of 17 cases . Ann Acad Med Singapore . 1997;26:409–414
  14. Tole DM , Anderton LC , Hayward JM . Orbital cellulitis demands early recognition, urgent admission and aggressive management . J Accid Emerg Med . 1995;12:151–153
  15. El-Silimy O . The place of endonasal endoscopy in the treatment of orbital cellulitis . Rhinology . 1995;33:244–245
  16. Givner LB . Periorbital versus orbital cellulitis . Pediatr Infect Dis J . 2002;21:1157–1158
  17. Jackson K , Baker SR . Clinical implications of orbital cellulitis . Laryngoscope . 1986;96:568–574
  18. Chang CH , Lai YH , Wang HZ , Su MY , Chang CW , Peng CF . Antibiotic treatment of orbital cellulitis: an analysis of pathogenic bacteria and bacterial susceptibility . J Ocul Pharmacol Ther . 2000;16:75–79
  19. Barone SR , Aiuto LT . Periorbital and orbital cellulitis in the Haemophilus influenzae vaccine era . J Pediatr Ophthalmol Strabismus . 1997;34:293–296
  20. Starkey CR , Steele RW . Medical management of orbital cellulitis . Pediatr Infect Dis J . 2001;20:1002–1005

PII: S1726-4901(09)70284-9

doi:10.1016/S1726-4901(09)70284-9

Journal of the Chinese Medical Association
Volume 69, Issue 9 , Pages 415-422, September 2006

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