ORBITAL CELLULITIS
Description
Suppurative inflammation of adipose and soft tissues of orbit is termed as orbital cellulitis. It occurs more frequently in children than adults. Orbital cellulitis and preseptal cellulitis are the major infections of the ocular adnexal and orbital tissues. Orbital cellulitis is an infection of the soft tissues of the orbit posterior to the orbital septum, differentiating it from preseptal cellulitis, which is an infection of the soft tissue of the eyelids and periocular region anterior to the orbital septum.
CAUSES
Orbital cellulitis can be caused by
1. Bacterial pathogens like Streptococcus and staphylococcus
2. Certain types of insect or spider bites also can transmit the bacteria that start the infection.
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5. For anaerobic infections Inj. Metronidazole 500 mg IV infusion 8 hourly, shifted to oral dose of 400 mg 8 hourly based on the clinical response for 2 weeks.
6. Oxymetazoline 0.05% nasal drops 2-3 drops in each nostril 2 times a day, in children: 0.025%.
7. Symptomatic therapy for pain: antipyretics and analgesics in usual doses.
8. Lubricating eyedrops/artificial tears: 1-2 hourly or antibiotic eye ointment 5 times a day to prevent exposure keratopathy.
Surgical treatment
Surgical drainage is indicated, if orbital abscess forms, based on clinical features, USG and CT scan findings; poor response or no response to the IV antibiotic therapy, or if there is a threat to ocular function. It includes procedures like
1. Tarsorrhaphy or Frost suture to prevent exposure keratopathy.
2. Sinusotomy/craniotomy for pus in paranasal sinus or brain abscess respectively.
3. All the patients must be carefully monitored for vision, fundus, corneal exposure, ocular motility, pupillary reaction, corneal sensations, proptosis, systemic status including CNS function.
Management
1. Warm compresses help in managing painful
The intravenous dosage in this case is 0.5 - 1 mg/kg IV (range: 0.5 - 2 mg/kg).
Treat with Amoxicillin 875 mg BID or Amoxicillin 500 mg TID x 5-7 days. Instruct client to take the medication as directed, and to complete all doses even if symptoms improve (Natal,
Pharmacokinetics: Oral dosing up to twelve hours for a majority of patients, also a 24-hour dosing interval for selected patients. Extended- release tablet for administered orally could contain up to 450mg.
The usual recommended dosage is 50 mg taken once a day, depending on how you respond to the medication;
days but with the antibiotic treatment can be reduced to 2-4 days. Bacterial conjunctivitis is highly communicable and is easily passed from person to person. 4. Natural defenses that help prevent eye infections include: the blinking reflex, tears, barriers such as the eyelid and orbital septum, presence of leukocytes and Langerhans’ cells also help as defense mechanisms. 5. There are preventative measures that could be taken to prevent the spread of this infection. Such measures are washing hands frequently, disinfecting common areas within the class room and simply educating the students on how the infection is spread. Case 1.5 1. This patient had necrotizing fasciitis caused by Streptococcus pyogenes. The presence of the gram-positive cocci growing in chains is the evidence of Streptococcus pyogenes. To consider the condition to be caused by Clostridium perfringens or gangrene there would need to be gram-positive rod-shaped bacteria obtained from the wound. 2. The below the knee amputation was the best solution for this type of infection because necrotizing fasciitis progresses and spreads rapidly, delaying surgical intervention increases the risk of mortality. 3. This bacterium is generally transmitted through person-to-person contact and sometimes can be found in unpasteurized milk. In this case the transmission was most likely related to the
PO: (Adults and Children ≥12 yr): 2–4 mg 3–4 times daily (not to exceed 32 mg/day) or 4–8 mg of extended-release tablets twice daily.
Following epithelial debridement, Riboflavin 0.1%, suspended in a dextran T500 20% solution, is applied every 3–5 min for at least 20 min to allow sufficient stromal absorption prior to UVA exposure (Wollensak et al., 2003a). Intra-operative pachymetry is advocated by many surgeons to monitor corneal thickness prior to UVA exposure and apply hypotonic Riboflavin drops if it thins excessively during Riboflavin administration. The central 8–9 mm of the cornea is then irradiated with UVA, at 3 mW/cm2 for 30 min.
Treatment of DNSI includes antibiotic therapy, airway management and surgical intervention. Management of DNSI is traditionally based on prompt surgical drainage of the abscess followed by antibiotics or nonsurgical treatment using appropriate antibiotics in the case of cellulitis. The advent of modern imaging techniques has made it possible to diagnose these complications earlier and to localize them exactly. Proper diagnosis and prompt management can effectively overcome the disease and provide a cure without complications. The main aim of our study was to share our experience in terms of presentation, clinical trends, common sites involved, bacteriology, management, complications, and outcomes. The study also emphasizes the importance
This is reason why I chose this topic and there is some information about these infections.
Surgical drainage is to decompress the metaphyseal space before pus erupts and spreads. The procedure includes injecting antibacterial solution into the cavity while it is being drained.
Therapeutic Dosage; Adult, child over 45 kg:300-600mg/day PO, or 0.4 mg/kg/hr. Child under 45 kg
Herpetic simplex keratitis, also known as herpetic keratoconjunctivitis and herpesviral keratitis, is a form of keratitis caused by recurrent herpes simplex virus (HSV) infection in the cornea. HSV infection is very common in humans. It has been estimated that one third of the world population have recurrent infection. Keratitis caused by HSV is the most common cause of cornea-derived blindness in developed nations. Therefore, HSV infections are a large and worldwide public health problem. The global incidence (rate of new disease) of herpes keratitis is roughly 1.5 million, including 40,000 new cases of severe monocular visual impairment or blindness each year
The boy, aged 12, was admitted to the Children's Otolaryngology Clinic because of severe headaches, left eye edema, fever, and general poor condition. In an interview for several days, severe headache, fever up to 40º C, orbital edema left and left cheek area. In laboratory tests high inflammatory parameters WBC-, CRP-, PCT. In the CT scan of the sinuses, massive inflammatory lesions were found in the left and left maxillary sinuses (left maxillary sinusoidal left maxillary sinusoidal, filled with changes in densities around 24 h, which may correspond to dense fluid). On the basis of a laryngological study and a CT scan of the sinus, the child was qualified for left sided sinus surgery. Dense purulent contents, extensive hypertrophic mucosal lesions, and polyposis-hypertrophic mucosal lesions were found during the procedure. Due to lack of clinical improvement, another operation was performed two days later - left frontal sinus surgery. During the treatment a large amount of purulent secretions and granulomatous necrotic lesions were found. To the left frontal sinus was drained. In spite of the treatment, the edema of the left eye ulcer persisted for another 6 days, so the patient was consulted
A microbial keratitis, also termed “corneal ulcer,” is a severe infection of the cornea which, after treatment, can often result in a scar in the region where it was located. If infection was located at or near the center of the cornea, this scar can result in reduced vision. There has to be loss of some of the cells of the outer layer of the cornea (termed the epithelium) for the offending organism to enter. Infection with Fusarium solani, one of the more than 20 known species of Fusarium, is usually the most virulent Fusarium infection. If untreated, Fusarium keratitis can result in permanent corneal scarring and injury.In the early stages of Fusarium species keratitis however hyphae grows horizontally in the cornea rather than vertically,the
Infected epithelial inclusion cyst mimicking subconjunctival abscess after strabismus surgery, J AAPOS. 2007 Mar 23