Periorbital cellulitis and paranasal sinusitis: a reappraisal

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pediatrics

Background:

• Periorbital and orbital cellulitis are frequently confused, despite differing causes and treatments.
• Accurate differentiation is vital for effective patient management.

Purpose of the Study:

• To clarify the distinctions between periorbital and orbital cellulitis.
• To categorize periorbital cellulitis based on etiology and clinical presentation.

Main Methods:

• Retrospective review of 56 periorbital cellulitis cases.
• Classification of patients into three distinct groups based on clinical findings and suspected etiology.

Main Results:

• Group 1: Periorbital swelling secondary to sinusitis (inflammatory edema).
• Group 2: Periorbital infection from skin barrier disruption (e.g., Staphylococcus aureus).
• Group 3: Periorbital infection associated with bacteremia (e.g., Haemophilus influenzae type b).
• True orbital cellulitis with proptosis/ophthalmoplegia is uncommon, often linked to severe sinusitis or trauma.

Conclusions:

• Periorbital cellulitis has varied causes, including sinusitis, skin infections, and bacteremia.
• Orbital cellulitis is rare and requires prompt, aggressive management.
• Distinguishing between these conditions is essential for appropriate therapeutic strategies.