AND PERIORBITAL CELLULITIS
Bacteremic periorbital cellulitis occurs in children between 6 and 30 months . S. pneumoniae and H. influenzae type b are the most common cause. The introduction of H. influenzae vaccination reduced the rate of this infection..12 In cellulitis related to trauma (including insect bite) or to extension from a neighboring soft tissue area, group A beta-hemolytic streptococci and S. aureus are the most likely pathogens..12Anaerobes could be associated with cellulitis that develops following chronic sinusitis or following sinusitis associated with dental infection. Clostridium perfringens infection can follow a penetrating wound involving a foreign body.
Similar organism are recovered from the infected sinuses and the site of complication.The most common pathogens in cellulitis and orbital abscesses are those seen in acute and chronic sinusitis, depending on the length and etiology of the primary sinusitis. These include S. pneumoniae, H. influenzae, S. aureus, Gram-negative anaerobic bacilli (Prevotella, Porphyromonas, Fusobacterium) ,Peptostreptococcus and microaerophilic streptococci. spp.)13. The organisms isolated in cavernous sinus thrombosis (CST) are S. aureus (50-70% of instances), Streptococcus spp. (20%) and Gram-negative anaerobic bacilli. Similar organisms can be recovered from subperiosteal and orbital abscesses and their corresponding maxillary sinusitis 14.
Inflammatory oedema and preseptal cellulitis
Cavernous sinus thrombosis
Sequential CT may be needed for follow-up. Cellulitis without an abscess is treated medically. However, if symptoms progress after 24 hours of antibiotics and no improvement occurs after 72 hours, surgical intervention is indicated.
6. Clinch, T.E., Palmon, F.E., Robinson, M.J. et al.: Microbial keratitis in children. Am J Ophthalmol 117:65, 1994.