Clinical Case Database / Category: Patient Management
Management of orbital cellulitis
Publication details
Priya Achar, Venkat Srinivasan
Foundation Years Journal, volume 7, issue 4, p.25 (123Doc Education, London, April 2013)
Abstract
A 6-year-old girl presented to accident and emergency with 2 days history of increasing swelling of left eye, fever, headaches and 1 day history of inability to open her left eye. Examination revealed left periorbital and lid oedema and restricted eye opening. A clinical diagnosis of periorbital cellulitis was made and she was treated with intravenous antibiotics, analgesics and topical nasal decongestants. Regular monitoring of her vision, extraocular movements and clinical symptoms were included in her observation chart. Subsequently, she developed conjunctival chemosis and restricted and painful left eye movements. Since the clinical signs worsened over 24 hours despite conservative medical treatment, a scan was requested. CT scan confirmed a small subperiosteal collection with ethmoid and maxillary sinusitis, needing further intervention. This case based discussion highlights potential serious complications of orbital
cellulitis and the importance of early diagnosis and timely management to
prevent fatal complications.
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Authors
Priya Achar
ENT Specialty Registrar
Arrowe Park Hospital
Wirral University Teaching Hospitals NHS Foundation Trust
Mersey Deanery
priya_orl@hotmail.co.uk
Venkat Srinivasan
ENT Consultant
Arrowe Park Hospital
Wirral University Teaching Hospitals NHS Foundation Trust
cheenu51@hotmail.com
References
1. Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute rhinosinusitis. Laryngoscope 1970;80:1414-28
2. Moloney JR, Badham NJ, McRae A. The acute orbit. Preseptal (periorbital) cellulitis, subperiosteal abscess and orbital cellultis due to rhinosinusitis. Journal of Laryngology and Otology Suppl. 1987; 12: 1-18
3. Brook I. Bacteriology of intracranial abscess in children. Journal of Neurosurgery. 1981; 54: 484-8
4. Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology. 1994; 101: 585-95
Disclaimers
Conflict Of Interest
The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).
Financial Statement
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Patient Consent statement
All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
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When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.