Podcast 872: Preseptal and Orbital Cellulitis

<p dir="ltr"><strong>Contributor: Meghan Hurley MD</strong></p> <p dir="ltr"><strong>Educational Pearls:</strong></p> <p dir="ltr">What is Cellulitis?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">A common and potentially serious bacterial skin infection.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Caused by various types of bacteria, with Streptococcus and Staphylococcus species being the most common.</p> </li> </ul> <p dir="ltr">What is Preseptal Cellulitis and why is it more serious than facial cellulitis?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Preseptal Cellulitis, also known as Periorbital Cellulitis, is a bacterial infection of the soft tissues in the eyelid and the surrounding area.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">This requires prompt and aggressive treatment to avoid progression into Orbital Cellulitis.</p> </li> </ul> <p dir="ltr">How is Preseptal Cellulitis treated?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Oral antibiotics for five to seven days.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">In the setting of trauma (scratching bug bites) Clindamycin or TMP-SMX (for MRSA coverage) and Amoxicillin-clavulanic acid or Cefpodoxime or Cefdinir.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">If there is no trauma, monotherapy with amoxicillin-clavulanic acid is appropriate.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Check immunization status against H.influenzae and adjust appropriately.</p> </li> </ul> <p dir="ltr">What is Orbital Cellulitis, how is it diagnosed, and why is it more serious than Preseptal Cellulitis?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Orbital cellulitis involves the tissues behind the eyeball and within the eye socket itself.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Key features include