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Orbital Cellulitis
Bernadette L. Koch, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Preseptal cellulitis: Inflammation anterior to orbital septum
              • Postseptal cellulitis: Inflammation posterior to orbital septum
              • Orbital septum: Periosteal reflection from bony orbit to tarsal plates of eyelids

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Sharma A et al: Pediatric orbital cellulitis in the Haemophilus influenzae vaccine era. J AAPOS. 19(3):206-10, 2015
                                        2. 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
                                        3. Block SL: Getting an eyeful of preseptal cellulitis. Pediatr Ann. 42(3):99-102, 2013
                                        4. Peña MT et al: Orbital complications of acute sinusitis: changes in the post-pneumococcal vaccine era. JAMA Otolaryngol Head Neck Surg. 139(3):223-7, 2013
                                        5. Meara DJ: Sinonasal disease and orbital cellulitis in children. Oral Maxillofac Surg Clin North Am. 24(3):487-96, 2012
                                        6. Bedwell J et al: Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg. 19(6):467-73, 2011
                                        7. DeMuri GP et al: Complications of acute bacterial sinusitis in children. Pediatr Infect Dis J. 30(8):701-2, 2011
                                        8. Mendenhall WM et al: Orbital pseudotumor. Am J Clin Oncol. 33(3):304-6, 2010
                                        9. Kapur R et al: MR imaging of orbital inflammatory syndrome, orbital cellulitis, and orbital lymphoid lesions: the role of diffusion-weighted imaging. AJNR Am J Neuroradiol. 30(1):64-70, 2009
                                        10. Maheshwari R et al: Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 28(2-3):196-9, 2009
                                        11. Sepahdari AR et al: MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. AJR Am J Roentgenol. 193(3):W244-50, 2009
                                        12. Yang M et al: Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 28(2-3):124-36, 2009
                                        13. Givner LB: Periorbital versus orbital cellulitis. Pediatr Infect Dis J. 21(12):1157-8, 2002
                                        14. Ambati BK et al: Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination. Ophthalmology. 107(8):1450-3, 2000
                                        15. Garcia GH et al: Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988-1998. Ophthalmology. 107(8):1454-6; discussion 1457-8, 2000
                                        16. Harris GJ: Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology. 101(3):585-95, 1994
                                        17. Handler LC et al: The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography. Neuroradiology. 33(1):15-8, 1991
                                        18. Chandler JR et al: The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 80(9):1414-28, 1970
                                        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

                                                  • Definitions

                                                    • Preseptal cellulitis: Inflammation anterior to orbital septum
                                                    • Postseptal cellulitis: Inflammation posterior to orbital septum
                                                    • Orbital septum: Periosteal reflection from bony orbit to tarsal plates of eyelids

                                                  IMAGING

                                                  • General Features

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Sharma A et al: Pediatric orbital cellulitis in the Haemophilus influenzae vaccine era. J AAPOS. 19(3):206-10, 2015
                                                                              2. 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
                                                                              3. Block SL: Getting an eyeful of preseptal cellulitis. Pediatr Ann. 42(3):99-102, 2013
                                                                              4. Peña MT et al: Orbital complications of acute sinusitis: changes in the post-pneumococcal vaccine era. JAMA Otolaryngol Head Neck Surg. 139(3):223-7, 2013
                                                                              5. Meara DJ: Sinonasal disease and orbital cellulitis in children. Oral Maxillofac Surg Clin North Am. 24(3):487-96, 2012
                                                                              6. Bedwell J et al: Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg. 19(6):467-73, 2011
                                                                              7. DeMuri GP et al: Complications of acute bacterial sinusitis in children. Pediatr Infect Dis J. 30(8):701-2, 2011
                                                                              8. Mendenhall WM et al: Orbital pseudotumor. Am J Clin Oncol. 33(3):304-6, 2010
                                                                              9. Kapur R et al: MR imaging of orbital inflammatory syndrome, orbital cellulitis, and orbital lymphoid lesions: the role of diffusion-weighted imaging. AJNR Am J Neuroradiol. 30(1):64-70, 2009
                                                                              10. Maheshwari R et al: Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 28(2-3):196-9, 2009
                                                                              11. Sepahdari AR et al: MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. AJR Am J Roentgenol. 193(3):W244-50, 2009
                                                                              12. Yang M et al: Orbital cellulitis in children-medical treatment versus surgical management. Orbit. 28(2-3):124-36, 2009
                                                                              13. Givner LB: Periorbital versus orbital cellulitis. Pediatr Infect Dis J. 21(12):1157-8, 2002
                                                                              14. Ambati BK et al: Periorbital and orbital cellulitis before and after the advent of Haemophilus influenzae type B vaccination. Ophthalmology. 107(8):1450-3, 2000
                                                                              15. Garcia GH et al: Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988-1998. Ophthalmology. 107(8):1454-6; discussion 1457-8, 2000
                                                                              16. Harris GJ: Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology. 101(3):585-95, 1994
                                                                              17. Handler LC et al: The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography. Neuroradiology. 33(1):15-8, 1991
                                                                              18. Chandler JR et al: The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 80(9):1414-28, 1970