Request PDF on ResearchGate | Celulitis orbitaria y periorbitaria. Revisión de casos | Objective To report the epidemiology, clinical features, management . PDF | Children with red swollen eyes frequently present to emergency Un agente causal infrecuente de celulitis periorbitaria en un niño. Preseptal cellulitis (PC) is defined as an inflammation of the eyelid and surrounding skin, whereas orbital . in preseptal celulitis, this diagnosis can easily be.
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This review summarizes the distinctive characteristics of preseptal and orbital cellulitis, with a focus on anatomic considerations, predisposing conditions. InTrODUcTIOn. Preseptal and orbital cellulitis are much more com- .. from the patients in the orbital celulitis group. The cultures of sinus. Preseptal and Orbital Cellulitis in Children. nvilnephtalyca.ga StarShipClinicalGuidelines/_Documents/Eye%nvilnephtalyca.ga
Orbital cellulitis usually begins deep to the orbital septum. Both are more common among children; preseptal cellulitis is far more common than orbital cellulitis.
Etiology Preseptal cellulitis is usually caused by contiguous spread of infection from local facial or eyelid injuries, insect or animal bites, conjunctivitis , chalazion , or sinusitis. Orbital cellulitis is most often caused by extension of infection from adjacent sinuses, especially the ethmoid sinus.
Less commonly, orbital cellulitis is caused by direct infection accompanying local trauma eg, insect or animal bite, penetrating eyelid injuries or contiguous spread of infection from the face or teeth or by hematogenous spread.
Pathogens vary by etiology and patient age. Streptococcus pneumoniae is the most frequent pathogen associated with sinus infection, whereas Staphylococcus aureus and S. Haemophilus influenzae type b, once a common cause, is now less common because of widespread vaccination.
Fungi are uncommon pathogens, causing orbital cellulitis in diabetic or immunosuppressed patients. Pathophysiology Because orbital cellulitis originates from large adjacent foci of fulminant infection eg, sinusitis separated by only a thin bone barrier, orbital infection can be extensive and severe.
This distinction is important, as orbital cellulitis, while less common, may be associated with significant visual and life-threatening sequelae, including optic neuropathy, encephalomeningitis, cavernous sinus thrombosis, sepsis, and intracranial abscess formation Lessner and Stern, ; Schmitt et al.
As such, rapid diagnosis and prompt initiation of therapy are important in order to minimize complications and optimize outcomes.
Medical management focuses primarily on aggressive antibiotic therapy while treating underlying predisposing factors such as sinusitis Lessner and Stern, ; Mills and Kartush, Surgical intervention may be indicated in cases of orbital cellulitis with an associated foreign body, although in cases of orbital cellulitis with an associated abscess, the precise need and timing of surgery are less clearly defined Harris, ; Howe and Jones, Some surgeons have advocated immediate surgical drainage, whereas other surgeons have reported that many of these abscesses resolve with medical therapy alone Harris, ; Howe and Jones, ; Rahbar et al.
Advancements in diagnostic technology and antibiotic therapy continue to evolve, and these improvements have reduced the associated morbidity and mortality of orbital cellulitis Chaudhry and Shamsi, ; Ambati and Ambati, The management of orbital cellulitis, however, remains challenging, and prompt diagnosis and expeditious treatment are paramount in minimizing complications and optimizing outcomes.
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In this review, we will discuss the distinctive characteristics of preseptal and orbital cellulitis, with a focus on anatomic considerations, predisposing factors, approaches to evaluation, and management options. Anatomy There are several important anatomic considerations that are particularly relevant in the setting of orbital cellulitis.
The distinction between preseptal and orbital cellulitis lies in the location and extent of the inflammatory process, and one of the major landmarks in this determination is the orbital septum. In preseptal cellulitis, the inflammatory process is localized anterior to the orbital septum, while in orbital cellulitis there is involvement of the soft tissues posterior to the orbital septum, including the orbital soft tissues.
The orbital septum is part of the anterior orbital connective tissue framework and provides the mechanical function of containing orbital fat.
Structurally, the orbital septum is a thin, fibrous, multilaminated structure that attaches peripherally to the periosteum of the orbital margin to form the arcus marginalis Koornneef, The extraocular rectus muscles of the eye originate at the annulus of Zinn in the posterior orbit, and intermuscular septa connecting these muscles establish an anatomic cone that divides the orbital space into intraconal and extraconal compartments.
In the posterior orbit, however, fascial connections between the rectus muscles are thin and may be incomplete, and as such, processes localized in the posterior orbit may extend between the intraconal and extraconal spaces. The subperiosteal space is a potential space that is present between the periorbita and the bony orbital walls. The periorbita has firm attachments to the bone at the orbital suture lines.
In other areas, however, the periorbita is relatively loosely adherent to the bony orbit. Hence, this potential subperiosteal space may provide an additional avenue for the spread of inflammatory or infectious processes.
From a vascular standpoint, several notable anatomic considerations exist.Fungi are uncommon pathogens, causing orbital cellulitis in diabetic or immunosuppressed patients.
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