眼眶周围和眼眶蜂窝织炎
小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 近期的鼻窦感染
- 近期的眼睑损伤
- 眼睛红肿
- 眼痛
- 视力下降
- 眼球突出
- 眼睑水肿
- 眼睑的蚊虫咬伤痕迹
- 睑腺炎或睑板腺囊肿
- 耳部或面部的感染
- 眼肌麻痹和复视
其他诊断因素
- 眶外伤
- 皮肤感染
- 球结膜水肿
- 眼周压痛
- 发热
- 眼睑红斑
- 眼压升高
- 头痛
- 不适感
- 既往口腔感染或口腔护理
- 眼眶骨折
- 眼内或眼眶异物
- 嗜睡
- 恶心/呕吐
- 流涕
危险因素
- 鼻窦炎
- 低龄
- 男性
- 未接种乙型流感嗜血杆菌疫苗的儿童
诊断性检查
首要检查
- 临床检查
- 鼻窦和眼眶增强 CT
- 白细胞计数
需考虑的检查
- 血培养
- 微生物拭子检测（结膜、鼻咽部或皮肤伤口）
- 头部和眼眶增强 MRI
- 腰椎穿刺：
治疗流程
眶周蜂窝织炎：病原体不明确
眶周蜂窝织炎：病原体明确
眼眶蜂窝织炎：病原体不明确
眼眶蜂窝织炎：病原体明确
撰稿人
作者
H. Jane Kim, MD
Oculofacial Plastic and Reconstructive Surgery
Department of Ophthalmology
Kaiser Permanente Medical Group
Union City
CA
利益声明
HJK declares that she has no competing interests.
Robert Kersten, MD
Professor of Clinical Ophthalmology
Department of Ophthalmology
University of California San Francisco
San Francisco
CA
利益声明
RK declares that he has no competing interests.
鸣谢
Dr H. Jane Kim and Dr Robert Kersten would like to gratefully acknowledge Dr Sandra Lora Cremers and Dr Sarosh Janjua, previous contributors to this topic. SLC and SJ declare that they have no competing interests.
同行评议者
David M. Ozog, MD
Director of Cosmetic Dermatology
Department of Dermatology
Cosmetic and Procedural Dermatology
Henry Ford Health System
Detroit
MI
利益声明
DMO declares that he has no competing interests.
I-Hui (Elaine) Wu, MD
Resident
Wilmer Eye Institute
Baltimore
MD
利益声明
IW declares that she has no competing interests.
Cristine Radojicic, MD
Staff Physician
Cleveland Clinic
Cleveland
OH
利益声明
CR declares that she has no competing interests.
Jonathan Smith, MD
Specialist Registrar in Ophthalmology
Royal Victoria Infirmary
Newcastle
UK
利益声明
JS declares that he has no competing interests.
鉴别诊断
- 眶假性肿瘤（特发性眼眶炎症）
- 甲状腺相关性眼病
- 全眼球炎
更多 鉴别诊断指南
- 眼部细菌感染的检查
- 2017 年 ENT UK 修订的眶蜂窝织炎流程图
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