Periorbital cellulitis: The Daily PANCE Blueprint

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Periorbital cellulitis: The Daily PANCE Blueprint

A 7-year-old male is brought to the ER with swelling and redness around his left eye. His symptoms started yesterday and have worsened. He recently had an upper respiratory tract infection. On physical exam, his left upper eyelid is erythematous, warm, and tender. He is afebrile and alert. His extraocular movements are intact and painless. There is no proptosis or visual disturbance. Which of the following is the most likely diagnosis?

A. Orbital cellulitis
B. Periorbital cellulitis
C. Allergic conjunctivitis
D. Cavernous sinus thrombosis
E. Acute dacryocystitis

Answer and topic summary

The answer is B. Periorbital cellulitis

Periorbital cellulitis is an infection of the eyelid and periorbital soft tissue anterior to the orbital septum. There is no involvement of the orbit itself. Causes include local spread from sinusitis, skin trauma, dacrocystitis, or conjunctivitis. Clinical features include eyelid erythema, warmth, swelling, and tenderness, often with low-grade fever. There is no pain with eye movement, no visual impairment, or proptosis. This helps distinguish it from orbital cellulitis. Diagnosis is primarily clinical. CT scan be done if orbit involvement is expected. Culture from open wounds or drainage can help identify the causative organism (usually Staph or Strep). Management includes antibiotics.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Orbital disorders ⇒ Periorbital (Preseptal) Cellulitis

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