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Celulite orbitária e periorbitária

Última revisão: 12 Dec 2025
Última atualização: 17 Sep 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • infecção dos seios nasais recente
  • lesão da pálpebra recente
  • vermelhidão e inchaço do olho
  • dor ocular
  • diminuição da visão
  • proptose
  • edema palpebral
  • picada de inseto na pálpebra
  • terçol ou calázio
  • infecção facial ou da orelha
  • oftalmoplegia e diplopia
Detalhes completos

Outros fatores diagnósticos

  • trauma orbitário
  • infecção cutânea
  • quemose
  • sensibilidade ao redor dos olhos
  • febre
  • eritema da pálpebra
  • pressão intraocular elevada
  • cefaleia
  • mal-estar
  • infecção ou tratamento dentário prévio
  • fratura orbital
  • corpo estranho no olho ou na órbita
  • torpor
  • náuseas/vômitos
  • secreção nasal
Detalhes completos

Fatores de risco

  • sinusite
  • idade jovem
  • sexo masculino
  • vacinação contra a Haemophilus influenzae do tipo b (Hib) ausente em crianças
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • exame clínico
  • tomografia computadorizada (TC) do seio nasal e de órbitas com meio de contraste
  • contagem leucocitária
Detalhes completos

Investigações a serem consideradas

  • hemocultura
  • swab microbiológico (conjuntiva, nasofaringe, feridas externas)
  • ressonância nuclear magnética (RNM) do crânio e das órbitas com meio de contraste
  • Ultrassonografia orbitária
  • punção lombar
Detalhes completos

Algoritmo de tratamento

AGUDA

celulite periorbitária: organismo causador não identificado

celulite periorbitária: organismo causador identificado

celulite orbitária: organismo causador não identificado

celulite orbitária: organismo causador identificado

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

Disclosures

DMO declares that he has no competing interests.

I-Hui (Elaine) Wu, MD

Resident

Wilmer Eye Institute

Baltimore

MD

Disclosures

IW declares that she has no competing interests.

Cristine Radojicic, MD

Staff Physician

Cleveland Clinic

Cleveland

OH

Disclosures

CR declares that she has no competing interests.

Jonathan Smith, MD

Specialist Registrar in Ophthalmology

Royal Victoria Infirmary

Newcastle

UK

Disclosures

JS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Robinson A, Beech T, McDermott AL, et al. Investigation and management of adult periorbital or orbital cellulitis. J Laryngol Otol. 2007;121:545-7. Abstract

Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80:1414-1428. Abstract

Hamed-Azzam S, AlHashash I, Briscoe D, et al. Common orbital infections ~ state of the art ~ Part I. J Ophthalmic Vis Res. 2018 Apr-Jun;13(2):175-82.Full text  Abstract

American Academy of Ophthalmology. Orbital cellulitis. Apr 2024 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Guidelines

    • 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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  • Patient information

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