Periorbital cellulitis

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Periorbital cellulitis

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Questions

USMLE® Step 1 style questions USMLE

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A 9-year-old boy is brought to the emergency department for evaluation of right eye pain of several hours duration. His mother states, “He’s been fighting something all week. He's been blowing his nose non-stop; I think he had a fever too.” He has no significant past medical history. Temperature is 38.5°C (101.3°F), pulse is 106/min, respirations are 18/min, and blood pressure is 112/84 mmHg. Physical examination reveals tenderness to palpation over the right orbit with associated right eyelid swelling with erythema. The patient reports significant pain with extraocular eye movement. Which of the following is the most likely diagnosis?  

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Summary

Periorbital cellulitis or preseptal cellulitis is an inflammation and infection of the eyelid and portions of skin around the eye, anterior to the orbital septum. It may be caused by breaks in the skin around the eye, and a subsequent spread of bacteria into the eyelid; infection of the sinuses around the nose (sinusitis); or from the spread of an infection elsewhere through the blood. Symptoms include eyelid redness, swelling, and tenderness around the eye, as well as fever and eyelid drooping. It is important to seek medical attention for periorbital cellulitis as it can cause serious complications if left untreated. Treatment typically includes antibiotics and may also include incision and drainage if an abscess is present.