Cellulitis

Bacterial infection of the lower dermis and subcutaneous tissue

Preseptal cellulitis

• Infection of the eyelid and surrouding skin anterior to the orbital septum

Aetiology

• Usually caused by contiguous spread of infection from local facial or eyelid trauma e.g. insect bites

Clinical features

• Tenderness, warmth, swelling, redness of the eyelid

Management

• Antibiotics (can be outpatient if orbital cellulitis definitively excluded)

Orbital cellulitis

• Infection of the orbital tissues posterior to orbital septum

Aetiology

• Direct extension from sinus

• Extension from focal orbital infection

• Post-operative

• Staphylococci

• Streptococci

• Coliforms

• H. influenzae

• Anaerobes

Clinical features

• Painful, especially on eye movements

• Proptosis

• Often associated with paranasal sinusitis

• Pyrexial

• Sight threatening

Investigations

• CT scan to identify orbital abscesses

• If any suggestion of muscle restriction or optic nerve dysfunction - CT scan

Management

• Broad spectrum antibiotics and monitor closely

• Sometimes an abscess will require drainage