Periorbital and orbital infections in children

Bacterial infections of the periorbital and orbital tissues range in severity from minor to life-threatening. Preseptal (periorbital) cellulitis is more common than orbital cellulitis and occurs quite frequently in children. A history of antecedent trauma or upper respiratory tract infection is present in more than half of all cases. Evaluation by computed tomography scans is an indispensable part of the diagnostic procedure. All cultures should be obtained before institution of antibiotic therapy. Initial therapy should begin with administration of broad-spectrum antibiotics with adjustments made in response to positive culture results. Response to antibiotics is usually prompt and the incidence of complications is low. If clinical improvement is slow, surgery should be performed early in the course of the disease to minimize the potential for significant complications such as cavernous sinus thrombosis.