Images in emergency medicine
Article Outline
Diagnosis
Orbital cellulitis. The orbital CT (Figure 2) revealed left eye cellulitis with pre- and postseptal involvement, orbital abscess, and full ethmoid sinus cavities. The patient began receiving intravenous antibiotics and underwent orbital abscess drainage, bilateral anterior sinus ethmoidectomy, and maxillary sinus antrostomy. Blood cultures confirmed the causative organism to be nontypeable Haemophilus influenzae.
Orbital cellulitis is a disease of children requiring aggressive treatment. Up to 81% of cases are associated with sinus infections that extend to the orbit.1 Classically, this disease presents with a constellation of findings that include periorbital erythema and edema, proptosis, chemosis, painful eye movements, ophthalmoplegia, and decreased visual acuity.2, 3 CT is the most effective imaging modality to diagnose and define the extent of this disease. Left untreated, the progression of this disease can result in devastating complications, including permanent vision loss, intracranial infection, and death.4
References
- . Periorbital and orbital cellulitis in Haemophilus influenzae vaccine era. J Pediatr Ophthalmol Strabismus. 1997;34:293–296
- . Periorbital versus orbital cellulites. Pediatr Infect Dis J. 2002;21:1157–1158
- . Orbital cellulitis in children. Int Ophthalmol Clin. 2001;41:71–86
- . Medical management of orbital cellulites. Pediatr Infect Dis J. 2001;20:1002–1005
PII: S0196-0644(06)00245-9
doi:10.1016/j.annemergmed.2006.02.011
© 2006 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Refers to article:
- Images in emergency medicine
