Preseptal and Orbital Cellulitis

Yıl 2014, Cilt: 4 Sayı: 03, 123 - 127, 01.09.2014

Emine Kalkan Akçay Gamze Dereli Can Nurullah Cagil

https://doi.org/10.5799/ahinjs.02.2014.03.0154

Öz

Preseptal cellulitis (PC) is defined as an inflammation of the eyelid and surrounding skin, whereas orbital cellulitis (OC) is an inflammation of the posterior septum of the eyelid affecting the orbit and its contents. Periorbital tissues may become infected as a result of trauma (including insect bites) or primary bacteremia. Orbital cellulitis generally occurs as a complication of sinusitis. The most commonly isolated organisms are Staphylococcus aureus, Streptococcus pneumoniae, S. epidermidis, Haempphilus influenzae, Moraxella catarrhalis and S. pyogenes. The method for the diagnosis of OS and PS is computed tomography. Using effective antibiotics is a mainstay for the treatment of PC and OC. There is an agreement that surgical drainage should be performed in cases of complete ophthalmoplegia or significant visual impairment or large abscesses formation. This infections are also at a greater risk of acute visual loss, cavernous sinus thrombosis, meningitis, cerebritis, endophthalmitis, and brain abscess in children. Early diagnosis and appropriate treatment are crucial to control the infection. Diagnosis, treatment, management and complications of PC and OC are summarized in this manuscript.

Anahtar Kelimeler

infection, cellulitis, orbita, preseptal, diagnosis, treatment

Preseptal and Orbital Cellulitis

Öz

Preseptal selülit (PS) göz kapağı ve çevresindeki dokunun iltihabi reaksiyonu iken orbital selülit (OS) orbitayı ve onun içeriğini etkileyen septum arkası dokuların iltihabıdır. Göz çevresi yapılar; travma (sıklıkla böcek ısırığı) veya primer bakteremiye bağlı olarak enfekte olur. Orbital selülit çoğunlukla sinüzite sekonder iltihabi olayın orbita içine ilerlemesiyle oluşur. Sıklıkla kültürlerden üretilen patojenler Staphylococcus aureus, Streptococcus pneumoniae, S. epidermidis, Haempphilus influenzae, Moraxella catarrhalis ve S. pyogenes’dir. Tanıda OS ve PS’yi ayırt etmek için önerilen yöntem bilgisayarlı tomografik görüntülemedir. Uygun antibiyoterapi OS ve PS’de tedavinin ana basamağıdır. Cerrahi drenaj total oftalmopleji, görsel kayıp veya büyük belirgin abse gelişiminde endikedir.Bu enfeksiyonlar çocuklarda akut görme kaybı, kavernöz sinus trombozu, menenjit, serebrit, endoftalmi, beyin absesi gibi komplikasyonlara neden olabilir. Bu nedenle bu enfeksiyonların erken tanınması ve doğru tedavi edilmesi oluşabilecek ciddi enfeksiyonların önlenmesi açısından çok önemlidir. Bu yazıda PS ve OS’nin tanı, tedavi, yönetim ve komplikasyonları özetlendi

Anahtar Kelimeler

Enfeksiyon, orbita, preseptal, selülit, tanı, tedavi

Kaynakça

• Handler LC, Davey IC, Hill JC, Lauryssen C. The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography. Neuroradiology 1991;33:15- 18.
• Schramm VL Jr, Curtin HD, Kennerdell JS. Evaluation of orbital cellulitis and results of treatment. Laryngoscope 1982;92:732-738.
• Krohel GB, Krauss HR, Winnick J. Orbital abscess presen- tation, diagnosis, therapy and sequelae. Ophthalmology 1982;89:492-498.
• Lessner A, Stern GA. Preseptal and orbital cellulitis. Infect Dis Clin North Am 1992;6:933-952.
• Givner LB. Periorbital versus orbital cellulitis. Pediatr Infect Dis J 2002;21:1157-1158.
• Wald ER. Periorbital and orbital infections. In: Long SS, Pick- ering LK, Prober CG, eds. Principles and Practice of Pediat- ric Infectious Diseases, 2nd ed. New York: Churchill Living- stone; 2003:508-513.
• Coats DK, Carothers TS, Brady-McCreery K, Paysse EA. Ocu- lar Infectious Diseases. In: Feigin RD, Cherry JD, et al. eds. Textbook of Pediatric Infectious Diseases. 5th ed. Philadel- phia: WB Saunders Company; 2004;790-792.
• Ambati BK, Ambati J, Azar N, et al. Periorbital and orbital cel- lulitis before and after the advent of Haemophilus influenza type B vaccination. Ophthalmol 1986;14:211-219.
• Van Dissel JT, de Keizer RJW. Bacterial infections of the orbit. Orbit 1998;17:227-35.
• Schwartz GR, Wright SW. Changing bacteriology of perior- bital cellulitis. Ann Emerg Med. 1996;28:617–620.
• Donahue SP, Schwartz G. Preseptal and orbital cellulitis in childhood. A changing microbiologic spectrum. Ophthalmol- ogy. 1998;105:1902–1905. discussion 1905-1906.
• Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases: A retrospective review of 262 cases. Int J Pediatr Otorhinolar- yngol. 2008;72:377–383.
• Rubinstein JB, Handler SD. Orbital and periorbital cellulitis in children. Head Nck Surg 1982;5:15-22.
• Chaudhry IA, Shamsi FA, Elzaridi E, et al. Inpatient presep- tal cellulitis: experience from a tertiary eye care centre. Br J Ophthalmol 2008 ;92:1337-1341.
• Steinkuller PG, Jones DB. Preseptal and orbital cellulitis and orbital abscess. In:Linberg JV, Oculoplastic & Orbital Emer- gencies. Noorwalk: Appleton & Lange, 1990:51-66.
• Jain A, Rubin PA. Orbital cellulitis in children. Int Ophthalmol Clin. 2001;41:71–86.
• Chandler JR, Langenbrunner DJ, Stevens ER. The patho- genesis of orbital complications in acute sinusitis. Laryngo- scope. 1970;80:1414–1428.
• Kloek CE, Rubin PA. Role of inflammation in orbital cellulitis. Int Ophthalmol Clin. 2006;46:57–68.
• Nageswaran S, Woods C, Benjamin D, et al. Orbital cellulitis in children. Pediatr Infect Dis J. 2006;25:695–699.
• Barone SR, Aiuto LT. Periorbital and orbital cellulitis in the Haemophilus influenzae vaccine era. J Pediatr Ophthalmol Strabismus 1997;34:293-296.
• McKinley SH, Yen MT, Miller AM, Yen KG. Microbiology of pe- diatric orbital cellulitis. Am J Ophthalmol 2007;144:497-501.
• Eustis HS, Mafee MF, Walton C, Mondonca J. MR imaging and CT of orbital infections and complications in acute rhino- sinusitis. Radiol Clin North Am. 1998;36:1165–1183.
• Goldman RD, Dolansky G, Rogovic AL. Predictors for ad- mission of children with periorbital cellulitis presenting to the pediatric emergency department. Pediatr Emerg Care 2008;24:279-283.
• Teele DW. Management of the child with red and swollen eye. Pediatr Infect Dis J 1983;2:258-262.
• Primeggia J, Cyriac G, Kumar P. Invasive orbital aspergillosis in an apparently immunocompetent host without evidence sinusitis. J Microbiol Infect Dis 2012;2:113-116.
• Georgakopoulos CD, Eliopoulou MI, Stasinos S, et al. Peri- orbital and orbital cellulitis: a 10-year review of hospitalized children. Eur J Ophthalmol 2010;20:1066-1072.
• Uy HS, Tuano PM. Preseptal and Orbital Cellulitis in a Devel- oping Country. Orbit 2007;26:33–37.