Facial and periorbital cellulitis with orbital involvement

Orbital cellulitis is a rare, serious and potentially fatal condition, usually associated with trauma to the eyelids, external ocular infection, upper respiratory tract infection and, especially, sinusitis. It is distinct from the more common periorbital cellulitis because it involves all contents of the orbit and may threaten both the vision and the life of the patient. It occurs with greater frequency in children. We report the case of a 34-year-old woman with severe facial and right periorbital cellulitis who rapidly developed orbital involvement, as shown by computed tomography. Apart from a bilateral retroauricular dermatitis, present for several years, the woman had been always healthy. Systemic antibiotics were started without delay and she recovered very well, with no ocular sequelae. This case illustrates that a subset of bacterial skin infections is becoming more aggressive and should be recognized and treated early.