Treatment Of Orbital Cellulitis Research Articles

Role of oral corticosteroids with adjunct to intravenous antibiotics in treatment of orbital cellulitis

Introduction: The standard treatment protocol of orbital cellulitis includes the use of broad-spectrum intravenous antibiotics. This study was done to evaluate the role of oral corticosteroids in the treatment of orbital cellulitis in order to address the inflammatory component. Methods: A prospective comparative interventional study was carried out on 17 cases of orbital cellulitis over 16 months. All the patients were treated with intravenous antibiotics and were allotted to Group A or B. The former consisted of eight cases (intravenous antibiotics) while group B consisted of nine cases (intravenous antibiotics and oral corticosteroids). The oral corticosteroids were started after 24 to 48 hours of initiation of antibiotics. The outcomes compared between the two groups were hospital stay, visual analogue score, temperature, peri-orbital edema, proptosis, visual acuity, extra-ocular movement and conjunctival chemosis. Results: The age of the participants ranged from 7 to 77 years with M:F = 6:11. The mean duration of hospital stay was 7.75±2.7 and 8.22± 2.53 days in group A and B. The result showed that the changes in the other parameters were significant on the 3rd day after starting treatment in both groups but insignificant between the groups at the end of 7th and 14th day. Conclusions: In our study, addition of oral corticosteroids to intravenous antibiotics showed no added beneficial effect over the useof intravenous antibiotics alone in the treatment of orbital cellulitis. However, it was noted that there was no furtherdeterioration of the disease with the use of steroids.

Pearls in the Evaluation and Treatment of Orbital Cellulitis in Adults

Pearls in the Evaluation and Treatment of Orbital Cellulitis in Adults

Orbital Cellulitis in West Texas

Purpose: Identify the risk factors, microbiology, complications, and treatment outcomes of orbital cellulitis in West Texas
 Study type: Retrospective chart review
 Main findings: 46 patients over a 10-year period were treated for orbital cellulitis. The majority of patients were adult and male. The most common causative organisms were staphylococcus aureus and polymicrobial infections. Abscess formation, either subperiosteal or intraorbital, were the most common complications. The majority of patients regained normal visual acuity following resolution of the infection.
 Conclusion: Prompt treatment of orbital cellulitis results in limited complications and resolution of visual loss

Orbital cellulitis in a tertiary institution in Nigeria: Improving outcomes

Background: Orbital infections could have untowards associated ocular and systemic morbidity. There is a need to reduce these complications to the barest minimum. Objectives: To improve outcomes of orbital cellulitis in Osogbo and suggest how to prevent complications. Materials and Methods: A 10-year retrospective study was conducted between 2003 and 2013 on cases admitted to the eye wards of LAUTECH Teaching Hospital, Osogbo, Nigeria. Clinical and sociodemographic data were extracted from the case notes. Data were entered into and analyzed with SPSS version 17 using descriptive statistics. Result: Of the 31 patients admitted for the treatment of orbital cellulitis, 20 (64.52%) were males and 11 (35.48%) were females. The age ranged between 2 and 85 years with a mean of 18.4 + 9.21 years, with 18 (56.06%) aged less than 20 years. The predisposing factors were mainly sinogenic, 18 (58.06%). Maxillary sinus constituted six (33.3%) whereas trauma and local spread constituted six (19.1%) each. Staphylococcus aureus was the only organism cultured in three (42.86%) whereas the remaining (57.14%) showed no growth. Complications recorded were orbital abscess in four and three each of panophthalmitis and optic atrophy. No death was recorded. Commonest surgery performed was bilateral intranasal anthrostomy in eight (25.8%) and drainage of orbital abscess. Visual acuity improved in four cases after treatment from blindness and visual impairment category to normal vision. Conclusion: The commonest cause of orbital infections was from adjacent sinus-related diseases. The problem of negative cultures still persists possibly due to indiscriminate use of antibiotics by the patients. Early presentation, effective antibiotics, and comanagement with other specialists improved outcome. No mortality was recorded.

Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: a case report

BackgroundThis case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis.Case presentationA 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis. Hematochemical and radiological examinations confirmed the cavernous sinus thrombosis and also showed septic pulmonary embolism. A blood culture indicated Streptococcus constellatus, which is a member of the Peptostreptococcus family, a saprophyte of the oral mucosa that can be pathogenic in immunocompromised persons. The odontogenic origin was then confirmed by dental radiography which showed a maxillary abscess. Her eye signs regressed after antibiotic and anticoagulant therapy.ConclusionsThis complex case shows the importance of a multidisciplinary approach for the management of orbital cellulitis, for the prompt diagnosis and treatment of eye injuries and possible complications, so as to avoid serious and permanent sequelae.

Orbital cellulitis- A review

Orbital cellulitis is an infection of the orbital soft tissues posterior to the orbital septum. It has the potential to be affect sight and function of the eye and extraocular tissues. Although it is commonly seen in the pediatric age group, adult orbital cellulitis is not uncommon. Infection usually originates from sinuses but sometimes the nidus of infection is in the eyelids, from retained vegetative foreign bodies, or very rarely from distant infection spreading to the orbit spread from blood. It is characterized by pain, proptosis, chemosis, diminution of vision, fever, periorbital erythema, and limitation of ocular motility. Historically orbital cellulitis was a sight and life-threatening condition. However, with the advent of high quality imaging, antibiotics and early surgical intervention to drain the orbital abscess when indicated, the chances of visual loss have reduced significantly. The purpose of this review is to describe current investigative and management paradigms in the treatment of orbital cellulitis and current recommendation in the management of complications resulting from it.

Periorbital cellulitis in children: Analysis of outcome of intravenous antibiotic therapy

ABSTRACTPeriorbital cellulitis is a relatively common ocular disease in the pediatric population. Early diagnosis of this disease with a prompt intervention is critical to avoid vision and life-threatening complications. In the last years, medical therapy has been expanding for the treatment of orbital cellulitis, instead of the standard surgical approach. The purpose of this study was to describe the outcome of treatment with intravenous antibiotic of periorbital cellulitis in children. A retrospective review of all children admitted with periorbital cellulitis in our hospital between January 2002 and July 2013 was conducted. Cases were divided in two subgroups, pre-septal and post-septal infection. The demographics, clinical findings, treatment and outcomes were analyzed. In total 110 children were included, 93 with pre-septal and 17 with post-septal cellulitis. The mean age was 3.5 years in children with pre-septal cellulitis and 5.5 years in those with post-septal cellulitis (p = 0.149). For both subgroups the most common predisposing factor was sinusitis. Intravenous antibiotic therapy was successful in all except one patient with an orbital abscess who required surgical intervention. In our study complete recovery was achieve in all (except for one) children with periorbital cellulitis treated with intravenous antibiotics only.

The hot orbit: Orbital cellulitis

Orbital cellulitis is an uncommon condition previously associated with severe complications. If untreated, orbital cellulitis can be potentially sight and life threatening. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. The infection most commonly originates from sinuses, eyelids or face, retained foreign bodies, or distant soources by hematogenous spread. It is characterized by eyelid edema, erythema, chemosis, proptosis, blurred vision, fever, headache, and double vision. A history of upper respiratory tract infection prior to the onset is very common especially in children. In the era prior to antibiotics, vision loss from orbital cellulitis was a dreaded complication. Currently, imaging studies for detection of orbital abcess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention.

Pseudomonas aeruginosa orbital cellulitis in four neutropenic patients

Four neutropenic patients on a haematology ward developed orbital cellulitis due to different strains of Pseudomonas aeruginosa over a 7-month period. Investigation of patients and the ward environment revealed two P. aeruginosa isolates indistinguishable from the infecting strains in a plastic washing bowl and a sink in a single cubicle respectively. These items were unlikely to have been the sources of the infecting strains but were a potential cross infection hazard. Treatment of orbital cellulitis is discussed briefly.

Computerized tomography in the diagnosis and treatment of orbital cellulitis.

Acute sinusitis remains the major cause of orbital cellulitis in children, despite the extensive use of antibiotics. Staging of orbital cellulitis on the basis of clinical signs is difficult but is easily achieved by computerized tomography. The CT findings in a series of 9 children with orbital cellulitis in different stages are reported. The information obtained by CT contributes to the selection of an adequate surgical approach, if a therapeutic trial with antibiotics fails.

Hypopyon and Orbital Cellulitis Associated With Haemophilus influenzae Type B Meningitis

Three children, 8 months to 2 years of age, demonstrated unusual manifestations in association with Haemophilus influenzae septicemia and meningitis. After one child had been diagnosed as having orbital cellulitis in conjunction with H influenzae meningitis, a second child, with orbital cellulitis and no clinical evidence of meningitis, had a lumbar tap indicative of a meningitis. A third child developed a hypopyon in association with H influenzae meningitis and septic arthritis of several joints. We report the problem of diagnosis and treatment of orbital cellulitis in the context of our cases and those previously reported.

Effect of lincomycin on orbital cellulitis in children.

Two cases of orbital cellulitis in children are described. Treatment with penicillin proved unsuccessful. Subsequent treatment with lincomycin parenterally produced rapid improvement and complete recovery from the infection.The authors suggest that lincomycin should be considered in treatment of orbital cellulitis in cases where penicillin has no effect.