Summary
Definition
History and exam
Key diagnostic factors
- 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
Other diagnostic factors
- 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
Risk factors
- sinusite
- idade jovem
- sexo masculino
- vacinação contra a Haemophilus influenzae do tipo b (Hib) ausente em crianças
Diagnostic investigations
1st investigations to order
- exame clínico
- tomografia computadorizada (TC) do seio nasal e de órbitas com meio de contraste
- contagem leucocitária
Investigations to consider
- hemocultura
- swab microbiológico (conjuntiva, nasofaringe, feridas externas)
- ressonância nuclear magnética (RNM) do crânio e das órbitas com meio de contraste
- Ultrassonografia orbitária
- punção lombar
Treatment algorithm
celulite periorbitária: organismo causador não identificado
celulite periorbitária: organismo causador identificado
celulite orbitária: organismo causador não identificado
celulite orbitária: organismo causador identificado
Contributors
Authors
Sudarshan Srivatsan, MD
Oculoplastics Fellow
Moran Eye Center
University of Utah
Salt Lake City
UT
Disclosures
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
Disclosures
RK declares that he has no competing interests.
Acknowledgements
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.
Peer reviewers
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
Divulgaciones
CR declares that she has no competing interests.
Jonathan Smith, MD
Specialist Registrar in Ophthalmology
Royal Victoria Infirmary
Newcastle
UK
Divulgaciones
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.
Referencias
Artículos principales
Robinson A, Beech T, McDermott AL, et al. Investigation and management of adult periorbital or orbital cellulitis. J Laryngol Otol. 2007;121:545-7. Resumen
Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80:1414-1428. Resumen
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.Texto completo Resumen
American Academy of Ophthalmology. Orbital cellulitis. Apr 2024 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Differentials
- Pseudotumor orbitário (inflamação orbitária idiopática)
- Doença ocular tireoidiana
- Panoftalmite
Más DifferentialsGuidelines
- 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
Más GuidelinesPatient information
Celulite e erisipela
Herpes-zóster: o que é?
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