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Periorbital Infections Differential Diagnoses

  • Author: Bobak Zonnoor , MD; Chief Editor: Robert E O'Connor, MD, MPH  more...
Updated: Dec 02, 2015

Diagnostic Considerations

Conditions to consider in the differential diagnosis of periorbital cellulitis include the following:

  • Angioedema
  • Insect bites
  • Cavernous sinus thrombosis
  • Chalazion
  • Internal and external hordeola
  • Idiopathic orbital inflammation (orbital pseudotumor)[55]
  • Mucormycosis
  • Nephrotic syndrome
  • Orbital cellulitis
  • Pott's puffy tumor[56, 57]
  • Periorbital necrotizing fasciitis

Conditions to consider in the differential diagnosis of blepharitis include the following[58] :

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Sebaceous cell carcinoma
  • Actinic keratosis
  • Keratoacanthoma

Conditions to consider in the differential diagnosis of dacryoadenitis include the following:

  • Sjögren syndrome
  • Sarcoidosis
  • Tumors - Cause about 25% of lacrimal gland enlargement[59]

Conditions to consider in the differential diagnosis of canaliculitis include the following:

Differential Diagnoses

Contributor Information and Disclosures

Bobak Zonnoor , MD Resident Physician, Department of Emergency Medicine, SUNY Downstate Medical Center, Kings County Hospital

Bobak Zonnoor , MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.


Elizabeth Fiedler, MD Clinical Instructor, Department of Emergency Medicine, Montefiore Medical Center-Weiler Division

Elizabeth Fiedler, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Richard H Sinert, DO Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Zach Kassutto, MD, FAAP Director, Pediatric Emergency Medicine, Capital Health System; Associate Professor of Pediatrics and Emergency Medicine, Drexel University College of Medicine; Attending Physician, St Christopher's Hospital for Children

Zach Kassutto, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Robert E O'Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Heart Association, Medical Society of Delaware, Society for Academic Emergency Medicine, Wilderness Medical Society, American Medical Association, National Association of EMS Physicians

Disclosure: Nothing to disclose.

Additional Contributors

R Gentry Wilkerson, MD, FACEP, FAAEM Assistant Professor, Coordinator for Research, Department of Emergency Medicine, University of Maryland School of Medicine

R Gentry Wilkerson, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.


Edmond A Hooker II, MD, DrPH, FAAEM Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine

Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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Periorbital cellulitis. This image shows an 8-year-old patient who presented with unilateral eyelid swelling and erythema.
Acute dacryocystitis.
Upper eyelid anatomy.
Lower eyelid anatomy.
Eye and lacrimal duct, anterior view.
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