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Periorbital cellulitis

Preseptal cellulitis

Periorbital cellulitis is an infection of the eyelid or skin around the eye.

Causes

Periorbital cellulitis can occur at any age, but commonly affects children under 18 months old.

This infection can occur after a scratch, injury, or bug bite around the eye, which allows germs to enter the wound. It can also extend from a nearby site that is infected, such as the sinuses.

Periorbital cellulitis is different than orbital cellulitis, which is an infection of the fat and muscles around the eye. Orbital cellulitis is a dangerous infection, which can cause lasting problems.

Symptoms

Symptoms include:

  • Redness around the eye or in the white part of the eye
  • Swelling of the eyelid, whites of eyes, and surrounding area

This condition does not often affect vision or cause eye pain.

Exams and Tests

The health care provider will examine the eye and ask about the symptoms.

Tests that may be ordered include:

Treatment

Antibiotics are given by mouth, by shots, or through a vein (intravenously; IV) to help fight the infection.

Outlook (Prognosis)

Periorbital cellulitis almost always improves with treatment. In rare cases, the infection spreads into the eye socket, resulting in orbital cellulitis.

When to Contact a Medical Professional

Call your provider right away if:

  • The eye becomes red or swollen
  • Symptoms get worse after treatment
  • Fever develops along with eye symptoms
  • It is difficult or painful to move the eye
  • The eye looks like it is sticking (bulging) out
  • There are vision changes

References

Durand ML. Periocular infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 118.

Olitsky SE, Hug D, Plummer LS, Stahl ED, Ariss MM, Lindquist TP. Orbital infections. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 634.

  • Haemophilus influenza organism

    Haemophilus influenza organism - illustration

    This picture shows the organism Haemophilus influenza. Infections caused by Haemophilus influenza usually occur in children under 6 years old and are extremely serious. Haemophilus (type B) is responsible for meningitis, periorbital cellulitis, buccal cellulitis and epiglottitis, septic arthritis, osteomyelitis, pericarditis, and bacteremia. The small organisms live within cells (intracellular) as shown in this picture. (Image courtesy of the Centers for Disease Control and Prevention.)

    Haemophilus influenza organism

    illustration

  • Periorbital cellulitis

    Periorbital cellulitis - illustration

    Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.

    Periorbital cellulitis

    illustration

  • Haemophilus influenza organism

    Haemophilus influenza organism - illustration

    This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenza, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenza vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenza (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.

    Haemophilus influenza organism

    illustration

    • Haemophilus influenza organism

      Haemophilus influenza organism - illustration

      This picture shows the organism Haemophilus influenza. Infections caused by Haemophilus influenza usually occur in children under 6 years old and are extremely serious. Haemophilus (type B) is responsible for meningitis, periorbital cellulitis, buccal cellulitis and epiglottitis, septic arthritis, osteomyelitis, pericarditis, and bacteremia. The small organisms live within cells (intracellular) as shown in this picture. (Image courtesy of the Centers for Disease Control and Prevention.)

      Haemophilus influenza organism

      illustration

    • Periorbital cellulitis

      Periorbital cellulitis - illustration

      Periorbital cellulitis is an acute infection of the tissues surrounding the eye, which may progress to orbital cellulitis with protrusion of the eyeball. Complications include meningitis.

      Periorbital cellulitis

      illustration

    • Haemophilus influenza organism

      Haemophilus influenza organism - illustration

      This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenza, one of the most common causes of childhood meningitis (prior to the widespread use of the H influenza vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenza (type B) is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.

      Haemophilus influenza organism

      illustration

     

    Review Date: 12/13/2017

    Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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