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)


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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Priya Achar

ENT Specialty Registrar
Arrowe Park Hospital
Wirral University Teaching Hospitals NHS Foundation Trust
Mersey Deanery

Venkat Srinivasan

ENT Consultant
Arrowe Park Hospital
Wirral University Teaching Hospitals NHS Foundation Trust


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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


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About the Clinical Cases Database

T​he 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.

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