Orbital Cellulitis: Defining Multidisciplinary Approach as the Need of the Hour

  • Semridhi Gupta
  • Shivam SharmaEmail author
Original Article


The aim of the study is to determine epidemiological profile of cases admitted with suspicion of pre or post septal cellulitis and to define and evaluate the various factors associated with the aetiology, presentation, diagnosis and management of orbital and preseptal cellulitis via a one year study of ten cases presenting to a tertiary care hospital in western Rajasthan, India. All patients presenting to our department or being transferred from other departments to us with the diagnosis of pre/post septal cellulitis from the March of 2017 to February 2018 were considered for this case series. Data compilation of these patients was done which included age, sex, chief complain, duration of illness, associated co-morbidities, time of presentation, management plan undertaken and associated radiological findings. All these aspects were then evaluated. Our study included 10 cases. Of these 8 were less than 14 years and 2 were over 50 years. Both the adults were female and were positive for Diabetes Mellitus type two. 80% of these patients presented between the duration of November to February with maximum (40%) in the month of December. In 7 of these 10 patients, the cellulitis was associated with underlying sinusitis. Six patients were admitted directly from ENT OPD while other 4 were being managed in other ward before being transferred to us. All patients were managed conservatively except 1 who required surgical intervention. Pre/post septal cellulitis is a dangerous condition in which prompt intervention needs to be undertaken as it can be difficult to predict what course it will follow. Radiological evaluation should be done in all cases as most cases are associated with an underlying sinus infection. Also, it is more common in paediatric age group and the patient may initially be referred to an ophthalmologist or a paediatrician in which case it becomes very important that a good working interdepartmental collaboration be present so that correct management plan can be followed.


Orbital cellulitis Preseptal cellulitis Orbital abscess Sinusitis Periorbital 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Chaudhry IA, Shamsi FA, Elzaridi E, Al-Rashed W, Al-Amri A, Al-Anezi F et al (2007) Outcome of treated orbital cellulitis in a tertiary eye care center in the middle East. Ophthalmology 114:345–354CrossRefGoogle Scholar
  2. 2.
    Hawkins DB, Clark RW (1977) Orbital involvement in acute rhinosinusitis. Lessons from 24 childhood patients. Clin Pediatr 16:464–471CrossRefGoogle Scholar
  3. 3.
    Singh B (1995) The management of sinogenic orbital complications. J Laryngol Otol 109:300–303Google Scholar
  4. 4.
    Moloney JR, Badham NJ, McRae A (1987) The acute orbit. Preseptal (periorbital) cellulitis, subperiosteal abscess and orbital cellulitis due to rhinosinusitis. J Laryngol Otol Suppl 12:1–18Google Scholar
  5. 5.
    Ferguson MP, McNab AA (1999) Current treatment and outcome in orbital cellulitis. Aust N Z J Ophthalmol 27:375–379CrossRefGoogle Scholar
  6. 6.
    Harris GJ (1994) Subperiosteal abscess of the orbit: age as a factor in the bacteriology and response to treatment. Ophthalmology 101:585–595CrossRefGoogle Scholar
  7. 7.
    Hornblass A, Herschorn BJ, Stern K, Grimes C (1984) Orbital abscess. Surv Ophthalmol 29:169–178CrossRefGoogle Scholar
  8. 8.
    Yen T, Yen G (2005) Effect of corticosteroids in the acute management of pediatric orbital cellulitis with subperiosteal abscess. Ophthal Plast Reconstr Surg 21:363–367CrossRefGoogle Scholar
  9. 9.
    Napierkowski D (2013) Uncovering common bacterial skin infections. Nurse Pract 38(3):30–38CrossRefGoogle Scholar
  10. 10.
    Mathew A, Craig E, Al-Mahmoud R et al (2013) Paediatric post-septal and pre-septal cellulitis: 10 years’ experience at a tertiary level children’s hospital. Br J Radiol 87:1033Google Scholar
  11. 11.
    Erickson B, Lee W (2015) Orbital cellulitis as a complication of sinusitis. J Nurse Pract 7(1):38–44Google Scholar
  12. 12.
    Elshafei AMK, Sayed MF, Abdallah RMA (2017) Clinical profile and outcomes of management of orbital cellulitis in Upper Egypt. J Ophthalmic Inflamm Infect 7:8CrossRefGoogle Scholar
  13. 13.
    Buchanan M, Muen W, Heinz P (2012) Management of periorbital and orbital cellulitis. Paediatr Child Health 22(2):72–77CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology and Head Neck SurgeryDr.S.N.Medical College and M.D.M.HospitalJodhpurIndia
  2. 2.JodhpurIndia
  3. 3.JodhpurIndia

Personalised recommendations