Periorbital Cellulitis, Signs and Symptoms

Periorbital cellulitis

Periorbital cellulitis, also known as preseptal cellulitis is an inflammation and infection of the eyelid and portions of skin around the eye, anterior to the septum. It may be caused by breaks in the skin around the eye, and subsequent spread to the eyelid; infection of the sinuses around the nose (sinusitis); or from spread of an infection elsewhere through the blood.

Periorbital cellulitis is more common in children than it is in adults. Symptoms of periorbital cellulitis include fever, redness, and swelling of the eyelid. Periorbital cellulitis happens when infection-causing bacteria (like staphylococcus or streptococcus) is introduced into the eyelid by a scratch, a bug bite, a sty, or a chalazion. There is generally redness and swelling of the eyelid and the surrounding area, but unlike orbital cellulitis (a more extensive infection involving deeper tissue), periorbital cellulitis does not cause protrusion of the eyeball (proptosis) or limit its movements. Periorbital cellulitis is most common in children under six years of age.

Causes

Staphylococcus and streptococcus species are commonly implicated. The advent of the Haemophilus influenzae vaccine has dramatically decreased the incidence of periorbital and orbital cellulitis

Signs and Symptoms of Periorbital cellulitis

There is generally redness and swelling of the eyelid and the surrounding area, but unlike orbital cellulitis, periorbital cellulitis does not cause protrusion of the eyeball or limit its movements. Signs of the primary infection are also often present (eg, nasal discharge and bleeding with sinusitis, periodontal pain and swelling with abscess)

Periorbital cellulitis

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Treatment of Cellulities Infection

Evaluation includes patient medical history for potential injury to that same area and physical examination. The diagnosis is confirmed through the physical examination. Blood tests (i.e. blood counts, blood culture, and blood chemistry) and an x-ray of the affected area will help the physician ascertain the severity or cause of the infection.

Treatment will include orally administered antibiotics for smaller, uncomplicated skin infections. Warm, wet compresses, elevation of the infected site, joint immobilization (splint) where appropriate, and rest will also be recommended.

Cellulitis of the hand may require hospitalization for IV antibiotics, due to the increased incidence of complications associated with infection (tendon sheath infections and abscess formation in the hand).

Facial cellulitis often requires more aggressive medical care. The advent of increasingly effective antibiotics, administered by injection, has enabled today's physician to treat many of these patients on an outpatient basis.

In most cases, Diabetics, the elderly, or the immunocompromised patient will be admitted to the hospital for treatment in most cases. All cases of cellulitis require close medical follow-up to document recovery.

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The Signs and Symptoms of Cellulitis Infection

The signs & symptoms of cellulitis begin as symptoms one would usually ignore at the onset. Mostly beginning as the result of an open wound, one would assume that the redness, swelling and irritation is because of the wound. However, this may lead to further infection. It is, thus, important to look out for the following cellulitis symptoms:

1. As mentioned earlier, the symptoms of cellulitis begin with redness, swelling and irritation of the affected area.

2. The infection then begins to cause some amount of pain and tenderness in the affected area.

3. Blisters may develop as a result of the infection. These are generally pus filled, i.e. they contain a yellowish-green infectious fluid. These tend to drain out or leak in case of cellulitis.

4. The affected area begins to swell up.

5. If the infection is not controlled it begins to spread into the rest of the blood throughout the body, causing high fever and chills.
The infection is considered serious when the following cellulitis signs and symptoms are observed:

1. As the infection spreads, other symptoms like nausea and vomiting begin.

2. The affected area becomes unusually swollen and begins to harden.

3. Numbness is experienced when the affected area is touched.

4. Cellulitis infection may occur in the face. This may further lead to severe eye infection which can be dangerous.

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What is Cellulitis Infection?

Cellulitis refers to a bacterial infection of the skin. This may occur on the face, leg, arm, hand, foot, or trunk. It is often seen as a complication of an insect bite, abrasion, cut, or puncture wound.

Cellulitis is more commonly found in the diabetic, elderly, or otherwise immunocompromised patient. A closely related infection is lymphangitis which represents an infection to the lymph channels.

Cellulitis refers to an infection also involving the skin's deeper layers: the dermis and subcutaneous tissue. The main bacteria involved in cellulitis are Streptococcus and Staphylococcus ("staph"), the same bacteria that cause many cases of impetigo. MRSA (methicillin-resistant Staph aureus) can also cause cellulitis. Sometimes, other bacteria (for example, Hemophilus influenzae, Pneumococcus, and Clostridium species) may cause cellulitis as well.

Since cellulitis spreads quickly and can lead to more serious infections, it is important to see a doctor if you suspect you have contracted it. Along with the symptoms listed above, cellulitis may also cause fever, chills and swollen glands. One may also observe red streaks around the affected area. A doctor can properly diagnose the condition and prescribe oral antibiotics like Keflex (cephalexin), usually taken for 10-14 days. The doctor will most likely want to recheck the area to be sure the symptoms are resolving.

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