Pediatric Orbital Cellulitis Complicated by Cavernous Sinus Thrombosis: A Pediatric Simulation Case for Residents

Orbital cellulitis is primarily a pediatric disease; although distinct from periorbital cellulitis, presenting symptoms may overlap, creating a challenge in diagnosis. If untreated, it can result in severe complications such as vision impairment, intracranial infection, cavernous sinus thrombosis (CST), and death. We created a simulation course to teach pediatric residents to recognize and treat this important diagnosis and its life-threatening complications.

This simulation features a 10-year-old patient who presents with eye pain and swelling due to orbital cellulitis. Learning objectives include recognizing and managing orbital cellulitis, identifying sequelae of orbital cellulitis (eg, CST), and liaising with surgical and intensive care consultants. Facilitators led a postsimulation debrief and didactic session, and participants completed an anonymous postcourse evaluation. The entire session took 60 minutes.

This simulation was performed 4 different times, involving a total of 27 participants, all of whom were pediatric residents. Twenty-three participants completed the postcourse survey. The average overall course was rated 5.7/6, and participants reported that the knowledge gained from the session will be helpful to them in their practice and will help improve patient outcomes (mean = 3.9/4).

Our simulation was well received by participants and provided them with an opportunity to learn how to manage a highly morbid complication of orbital cellulitis, a common pediatric condition. This educational session can be completed in an hour and requires no advanced preparation for participants. This simulation can be adapted to run in a low-fidelity environment across a range of medical subspecialty training programs.