Distinguishing between Orbital and Preseptal Cellulitis
Some medical conditions have signs and symptoms that significantly overlap, making a diagnosis a little more difficult. Epididymitis, testicular torsion, and torsion of the testicular appendage are examples, but orbital and preseptal cellulitis are others that can cause significant diagnostic confusion.Both conditions are more common in children than in adults, and preseptal or periorbital cellulitis is more common in children under 5. The preseptal and orbital spaces are separated by only a thin membranous septum that originates in the orbital periosteum and inserts into the tarsal plates. It is only this thin septum that stands as a barrier against progression of the preseptal infection into the orbit.Both conditions may present with eye pain, eyelid swelling, and erythema. The occasional bee sting or mosquito bite near the eye, with its dramatic swelling of loose areolar connective tissue, can cause similar diagnostic confusion. Several years ago I had a patient with what appeared to be a localized reaction to an insect bite that subsequently turned out to an early preseptal cellulitis. On the other hand, allergic reactions that cause periorbital swelling and conjunctival chemosis are less difficult to differentiate because of the bilateral presentation.Preseptal cellulitis once had implications that were more serious. Haemophilus influenzae type b was one of the most frequent etiologies of these infections, and it was common practice for all of these children to underg...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
More News: Allergy & Immunology | Amoxicillin | Augmentin | Back Pain | Blogging | Ceftriaxone | Cellulitis | Children | Clindamycin | Emergency Medicine | Eyes | Haemophilus Influenzae (Hib) | HIB Vaccine | Hospitals | Influenza Vaccine | Insect Bites & Stings | Learning | Lumbar Puncture | Metronidazole | Opthalmology | Pain | Pain Management | Pediatrics | Pneomococcal Vaccine | Rocephin | Sinusitis | Skin | Staphylococcus Aureus | Universities & Medical Training | Vaccines