Current Guidelines for the Management of Orbital Cellulitis

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Abstract

Orbital cellulitis and subperiosteal abscess are well-defined orbital infections with potential vision- and life-threatening sequelae. Bacterial sinusitis remains the leading cause. All patients with sinusitis-related infections are treated with dual-therapy, broad-spectrum intravenous antibiotics that include coverage for methicillin-resistant Staphylococcus aureus (MRSA) and with oxymetazoline nasal spray to promote physiological sinus drainage. Based on studies identifying a trend from simple aerobic pathogens and responsive infections in younger children to mixed aerobic-anaerobic pathogens causing refractory infections in older children and adults, a surgical management protocol that considers multiple variables, including patient age, is applied. Despite the emergence in recent decades of more virulent pathogens, including MRSA, the management protocol remains valid—appropriately triaging aggressive infections to timely intervention and avoiding unnecessary surgery in the majority of pediatric patients.

Keywords

Orbital cellulitis Orbital subperiosteal abscess Orbital infections Bacterial sinusitis Methicillin-resistant Staphylococcus aureus (MRSA) 

Abbreviations

APD

Afferent pupillary defect

SPA

Subperiosteal abscess

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.New York Eye and Ear Infirmary of Mount SinaiNew YorkUSA
  2. 2.Medical College of Wisconsin Eye InstituteMilwaukeeUSA

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