Periorbital Infections Follow-up

  • Author: R Gentry Wilkerson, MD; Chief Editor: Robert E O'Connor, MD, MPH   more...
 
Updated: Jul 10, 2011
 

Further Inpatient Care

  • Further inpatient care is indicated for the treatment of periorbital cellulitis in the pediatric population for the administration of intravenous antibiotics.
  • Further inpatient care is indicated in any patient who is septic or has orbital involvement.
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Complications

  • Periorbital cellulitis
    • Toxic shock syndrome
    • Eschar formation leading to scarring
    • Meningitis
    • Orbital cellulitis
    • Periorbital necrotizing fasciitis is a potential complication with devastating results. The mortality is reported to be 14.4%.[67]
  • Blepharitis
    • Hordeolum
    • Chalazion
    • Scarring of the cornea, which could lead to blindness
    • Trichiasis (misdirection of eyelashes)
    • Corneal infection
    • Patients with blepharitis undergoing intraocular surgery may have an increased risk of developing endophthalmitis.
  • Dacryocystitis
    • Dacryocystitis may be associated with periorbital cellulitis. Rarely, it may be associated with orbital cellulitis or abscess formation. This is usually prevented by the orbital septum, which surrounds the lacrimal sac.[68]
    • Complications may occur during a dacryocystorhinostomy, including hemorrhage, infection, and CSF leakage.
  • Canaliculitis - Epiphora due to failure of tear film to appropriately drain through the lacrimal system
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Prognosis

  • Periorbital cellulitis - With appropriate antibiotics, the prognosis is good.
  • Blepharitis - Typically, this is a chronic disease with waxing and waning of symptoms.
  • Dacryoadenitis
    • Prognosis of the acute form is excellent as it is a self-limiting process.
    • Prognosis of the chronic form depends on the underlying disease process.
  • Dacryocystitis - Success rates for dacryocystorhinostomy are good. External procedures fare better due to the ability to create a larger ostium.
  • Canaliculitis - Prognosis is excellent with definitive treatment by canaliculotomy with curettage.
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Patient Education

  • Periorbital cellulitis - For excellent patient education resources see eMedicine's patient education article, Cellulitis.
  • Blepharitis
    • Blepharitis Fact Sheet is available for purchase from the American Academy of Ophthalmology.[69]
    • The use of eye makeup, especially eyeliner, can cause acute exacerbations by plugging the glands.[70]
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Contributor Information and Disclosures
Author

R Gentry Wilkerson, MD  Assistant Professor, Director of Research, Emergency Medicine Residency Program, University of South Florida College of Medicine, Tampa General Hospital

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

Disclosure: Nothing to disclose.

Coauthor(s)

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

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians and 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.

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.

Specialty Editor Board

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

Douglas Lavenburg, MD  Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

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 College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

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Preseptal cellulitis. This image shows an 8-year-old patient who presented with unilateral eyelid swelling and erythema.
Acute dacryocystitis.
 
 
 
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