Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- recent sinus infection
- recent eyelid injury
- redness and swelling of eye
- ocular pain
- decreased vision
- proptosis
- eyelid oedema
- insect bite on eyelid
- stye or chalazion
- ear or facial infection
- ophthalmoplegia and diplopia
Outros fatores diagnósticos
- orbital trauma
- skin infection
- chemosis
- tenderness around eye
- fever
- eyelid erythema
- elevated intra-ocular pressure
- headache
- malaise
- previous dental infection or dental work
- orbital fracture
- foreign body in eye or orbit
- drowsiness
- nausea/vomiting
- nasal discharge
Fatores de risco
- sinusitis
- young age
- male sex
- lack of Hib vaccine in children
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical examination
- CT sinus and orbits with contrast medium
- WBC count
Investigações a serem consideradas
- blood culture
- microbiology swab (conjunctiva, nasopharynx, external wounds)
- MRI head and orbits with contrast medium
- Orbital ultrasonography
- lumbar puncture
Algoritmo de tratamento
peri-orbital cellulitis: causative organism not identified
peri-orbital cellulitis: causative organism identified
orbital cellulitis: causative organism not identified
orbital cellulitis: causative organism identified
Colaboradores
Autores
Sudarshan Srivatsan, MD
Oculoplastics Fellow
Moran Eye Center
University of Utah
Salt Lake City
UT
Declarações
SS declares that he has no competing interests.
Robert Kersten, MD, FACS, FASOPRS
Professor of Clinical Ophthalmology
Division Chief, Oculoplastics
Moran Eye Center
University of Utah
Salt Lake City
UT
Declarações
RK declares that he has no competing interests.
Agradecimentos
Dr Sudarshan Srivatsan and Dr Robert Kersten would like to gratefully acknowledge Dr Sandra Lora Cremers, Dr Sarosh Janjua, and Dr H. Jane Kim, previous contributors to this topic. SLC, SJ and HJK declare that they have no competing interests.
Revisores
David M. Ozog, MD
Director of Cosmetic Dermatology
Department of Dermatology
Cosmetic and Procedural Dermatology
Henry Ford Health System
Detroit
MI
Declarações
DMO declares that he has no competing interests.
I-Hui (Elaine) Wu, MD
Resident
Wilmer Eye Institute
Baltimore
MD
Declarações
IW declares that she has no competing interests.
Cristine Radojicic, MD
Staff Physician
Cleveland Clinic
Cleveland
OH
Declarações
CR declares that she has no competing interests.
Jonathan Smith, MD
Specialist Registrar in Ophthalmology
Royal Victoria Infirmary
Newcastle
UK
Declarações
JS declares that he has no competing interests.
Diagnósticos diferenciais
- Orbital pseudo-tumour (idiopathic orbital inflammation)
- Thyroid eye disease
- Panophthalmitis
Mais Diagnósticos diferenciaisDiretrizes
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
- Appropriateness criteria: orbital imaging and visual loss - child
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