Orbital cellulitis

Orbital cellulitis -Involvement of orbital tissue behind the orbital septum with infection or inflammation

A serious infection that affects the muscle and fat in the orbit - ie infection of the deep tissue of the orbit

seen more commonly in children but can happen at any age

gender distribution equal

peak incidence in winter and early spring & less frequent in summer months

spread can be ◘ direct ( sinuses , dental ) insect bites , impetigo◘ exogenous ( trauma or surgery ) e.g direct penetrating injury or orbital fractures◘ endogenous ( haematogenous )

rare complication of bacterial rhinosinusitis ( particularly pansinusitis & ethmoid sinuslitis )◘ sinuses closely associated with orbit◘ about 13 - 5.6 % of of sinusitis can cause orbital cellulitis and 80 % of all complications of acute rhinosinusitis are orbital

pathogens involved include Streptococcus pneumonia , Staphylococcus aureus , Streptococcus pyogenes , Haemophilus influenzae ( ↓↓ H influenzae due to vaccinations now ) ↑↑ increasing incidence of MRSA ( consider risk factors MRSA )

unilateral in > 90 % of cases

a preceding URTI / sinusitis may be noted

patients -unwell with fever , nausea , vomiting ( constitutional symptoms )

pain , , frontal headache...