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Orbital Cellulitis Essay

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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
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