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Celulite orbitária e periorbitária

Last reviewed: 14 Aug 2025
Last updated: 17 Sep 2024

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
Full details

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
Full details

Risk factors

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

Diagnostic investigations

1st investigations to order

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

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
Full details

Treatment algorithm

ACUTE

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

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

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.
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  • Guidelines

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  • Patient information

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