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orbital_cellulitis [2024/03/25 13:41] – Scott Larsonorbital_cellulitis [2025/04/18 20:40] (current) – external edit 127.0.0.1
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 ====== Orbital Cellulitis in Children ====== ====== Orbital Cellulitis in Children ======
  
-==== University of Iowa Stead Family Children’s Hospital +====University of Iowa Stead Family Children’s Hospital Pediatric Orbital (Post-Septal) Cellulitis Guidelines====
-Pediatric Orbital (Post-Septal) Cellulitis Guidelines ====+
  
 ===Objective=== ===Objective===
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 ===Inclusion Criteria=== ===Inclusion Criteria===
-- Pediatric patients age ≥ 2 months and < 18 years old with a diagnosis of orbital cellulitis +  * Pediatric patients age ≥ 2 months and < 18 years old with a diagnosis of orbital cellulitis 
-- Hemodynamically stable without features of shock or critical illness+  * Hemodynamically stable without features of shock or critical illness
  
 ===Exclusion Criteria (that may warrant additional studies/interventions)=== ===Exclusion Criteria (that may warrant additional studies/interventions)===
-- Clinical features concerning for shock and/or critical illness, including toxin-mediated shock +  * Clinical features concerning for shock and/or critical illness, including toxin-mediated shock 
-- Primary or acquired immunodeficiency, such as malignancy, drug-induced (chemotherapy, immunomodulator therapy or chronic high-dose steroids) or HIV +  * Primary or acquired immunodeficiency, such as malignancy, drug-induced (chemotherapy, immunomodulator therapy or chronic high-dose steroids) or HIV 
-- Recent history of surgery at the site +  * Recent history of surgery at the site 
-- Environmental contamination including bite wound, presence of a foreign body or marine or freshwater exposure+  * Environmental contamination including bite wound, presence of a foreign body or marine or freshwater exposure
  
 ===Diagnosis=== ===Diagnosis===
 Manifestations of OC can be unilateral or bilateral and suggested by the following orbital signs:  Manifestations of OC can be unilateral or bilateral and suggested by the following orbital signs: 
-• Eye pain and/or pain with extraocular eye movements +  * Eye pain and/or pain with extraocular eye movements 
-• Impairment of extraocular eye movements +  * Impairment of extraocular eye movements 
-• Proptosis +  * Proptosis 
-• Decreased visual acuity and/or abnormal pupillary response +  * Decreased visual acuity and/or abnormal pupillary response 
-• Conjunctival chemosis+  * Conjunctival chemosis
  
 Eyelid and periorbital edema and erythema with ptosis are signs that accompany both pre-septal and post-septal cellulitis. Systemic symptoms like fever, headache and malaise may be present with either OC or pre-septal cellulitis. Eyelid and periorbital edema and erythema with ptosis are signs that accompany both pre-septal and post-septal cellulitis. Systemic symptoms like fever, headache and malaise may be present with either OC or pre-septal cellulitis.
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   * Swabs of conjunctiva should not be sent for culture.   * Swabs of conjunctiva should not be sent for culture.
  
-===First Line Antibiotic Recommendations based on presence or absence of intracranial extension=== +==First Line Antibiotic Recommendations based on presence or absence of intracranial extension== 
- See above for definition and examples of intracranial extension, if unclear, consult with ID.+See above for definition and examples of intracranial extension, if unclear, consult with ID.
 ==First-line therapy (without concern for intra-cranial extension)== ==First-line therapy (without concern for intra-cranial extension)==
   * Vancomycin IV (dosing per UISFCH guideline), AND   * Vancomycin IV (dosing per UISFCH guideline), AND
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 ===Abbreviations=== ===Abbreviations===
-        IV: Intravenous +IV: Intravenous, OC: Orbital Cellulitis, ID: Infectious Disease 
-OC: Orbital Cellulitis  +
- ID: Infectious Disease +
  
 ===References=== ===References===