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Orbital Cellulitis
H. Christian Davidson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Preseptal cellulitis
                • Infection limited to superficial periorbita
              • Intraorbital (postseptal) cellulitis
                • Infection posterior to orbital septum
                • Extraconal &/or intraconal
            • Definitions

              • Orbital septum
                • Connective tissue plane that acts as diaphragm at anterior boundary of orbit
                • Attaches to orbital periosteum peripherally
                • Inserts into lid retractor structures centrally
              • Phlegmon
                • Infectious infiltrate without discrete abscess
              • Subperiosteal abscess
                • Complication of cellulitis

            IMAGING

            • General Features

              • Imaging Recommendations

                • CT Findings

                  • MR Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microbiology

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Marchiano E et al: Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data. Laryngoscope. 126(3):554-9, 2016
                                        2. Davies BW et al: C-reactive protein as a marker for initiating steroid treatment in children with orbital cellulitis. Ophthal Plast Reconstr Surg. 31(5):364-8, 2015
                                        3. Erickson BP et al: Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis. Orbit. 34(3):115-20, 2015
                                        4. Le TD et al: The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 18(3):271-7, 2014
                                        5. Smith JM et al: Predicting the need for surgical intervention in pediatric orbital cellulitis. Am J Ophthalmol. 158(2):387-394.e1, 2014
                                        6. Philip J et al: Post-traumatic orbital cellulitis. Br J Oral Maxillofac Surg. 48(4):326, 2010
                                        7. Babar TF et al: Risk factors of preseptal and orbital cellulitis. J Coll Physicians Surg Pak. 19(1):39-42, 2009
                                        8. Fincham G et al: Orbital cellulitis: assessment and management. Br J Hosp Med (Lond). 70(7):M108-10, 2009
                                        9. Kapur R et al: MR imaging of orbital inflammatory syndrome, orbital cellulitis, & orbital lymphoid lesions: role of diffusion-weighted imaging. AJNR Am J Neuroradiol. 30(1):64-70, 2009
                                        10. Migirov L et al: Endoscopic sinus surgery for medial orbital subperiosteal abscess in children. J Otolaryngol Head Neck Surg. 38(4):504-8, 2009
                                        11. Ryan JT et al: Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess. Otolaryngol Head Neck Surg. 140(6):907-11, 2009
                                        12. Yang M et al: Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 28(2-3):124-36, 2009
                                        13. Chaudhry IA et al: Inpatient preseptal cellulitis: experience from a tertiary eye care centre. Br J Ophthalmol. 92(10):1337-41, 2008
                                        14. Miller A et al: Infantile orbital cellulitis. Ophthalmology. 115(3):594, 2008
                                        15. Beech T et al: Paediatric periorbital cellulitis and its management. Rhinology. 45(1):47-9, 2007
                                        16. McKinley SH et al: Microbiology of pediatric orbital cellulitis. Am J Ophthalmol. 144(4):497-501, 2007
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Preseptal cellulitis
                                                      • Infection limited to superficial periorbita
                                                    • Intraorbital (postseptal) cellulitis
                                                      • Infection posterior to orbital septum
                                                      • Extraconal &/or intraconal
                                                  • Definitions

                                                    • Orbital septum
                                                      • Connective tissue plane that acts as diaphragm at anterior boundary of orbit
                                                      • Attaches to orbital periosteum peripherally
                                                      • Inserts into lid retractor structures centrally
                                                    • Phlegmon
                                                      • Infectious infiltrate without discrete abscess
                                                    • Subperiosteal abscess
                                                      • Complication of cellulitis

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • CT Findings

                                                        • MR Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microbiology

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Marchiano E et al: Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data. Laryngoscope. 126(3):554-9, 2016
                                                                              2. Davies BW et al: C-reactive protein as a marker for initiating steroid treatment in children with orbital cellulitis. Ophthal Plast Reconstr Surg. 31(5):364-8, 2015
                                                                              3. Erickson BP et al: Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis. Orbit. 34(3):115-20, 2015
                                                                              4. Le TD et al: The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 18(3):271-7, 2014
                                                                              5. Smith JM et al: Predicting the need for surgical intervention in pediatric orbital cellulitis. Am J Ophthalmol. 158(2):387-394.e1, 2014
                                                                              6. Philip J et al: Post-traumatic orbital cellulitis. Br J Oral Maxillofac Surg. 48(4):326, 2010
                                                                              7. Babar TF et al: Risk factors of preseptal and orbital cellulitis. J Coll Physicians Surg Pak. 19(1):39-42, 2009
                                                                              8. Fincham G et al: Orbital cellulitis: assessment and management. Br J Hosp Med (Lond). 70(7):M108-10, 2009
                                                                              9. Kapur R et al: MR imaging of orbital inflammatory syndrome, orbital cellulitis, & orbital lymphoid lesions: role of diffusion-weighted imaging. AJNR Am J Neuroradiol. 30(1):64-70, 2009
                                                                              10. Migirov L et al: Endoscopic sinus surgery for medial orbital subperiosteal abscess in children. J Otolaryngol Head Neck Surg. 38(4):504-8, 2009
                                                                              11. Ryan JT et al: Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess. Otolaryngol Head Neck Surg. 140(6):907-11, 2009
                                                                              12. Yang M et al: Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 28(2-3):124-36, 2009
                                                                              13. Chaudhry IA et al: Inpatient preseptal cellulitis: experience from a tertiary eye care centre. Br J Ophthalmol. 92(10):1337-41, 2008
                                                                              14. Miller A et al: Infantile orbital cellulitis. Ophthalmology. 115(3):594, 2008
                                                                              15. Beech T et al: Paediatric periorbital cellulitis and its management. Rhinology. 45(1):47-9, 2007
                                                                              16. McKinley SH et al: Microbiology of pediatric orbital cellulitis. Am J Ophthalmol. 144(4):497-501, 2007