How to Treat of Periorbital Cellulitis

Periorbital cellulitis is also known as preseptal cellulitis. It is an infection of the eyelid and skin around the eyes that leads to inflammation. It can be caused by an infected wound in that area or via spread of another infection from the blood or sinuses. One danger of periorbital cellulitis is that it can evolve into orbital cellulitis, which is a much more serious condition.

Instructions

• 1

  Ensure that it is not orbital cellulitis. Orbital cellulitis is a very serious condition than can cause the eyes to bulge, as well as limitations of eye movement. Orbital cellulitis can also cause eye movement to be painful and vision to be limited. If orbital cellulitis is suspected, hospitalization and IV antibiotics are immediately required.

• 2

  Attempt to determine the source of infection. Many cases of periorbital cellulitis are due to the spreading of sinusitis, and if that is the case a culture of the sinus fluid may help to identify the cause of the infection. If there is a wound in the periorbital area and it is suspected that the cellulitis is due to an infected cut, gram-negative bacteria should also be considered as a possible pathogen.

• 3

  Outpatient treatment for people who have been infected outside of a hospital is generally done using oral antibiotics. For children, 500 milligrams of amoxicillin per day is an effective dose, which is raised to 850 milligrams for adults. Infections that occur outside of hospitals are generally treated differently than those that occur in hospitals because the types of bacteria present in hospitals are different than those found outside of a health care setting. Because of the widespread use of antibiotics in hospitals, infections contracted there generally involve antibiotic-resistant bacteria.

• 4

  For patients that are allergic to penicillins, or in patients who may have gotten the infection from a hospital (where antibiotic-resistant bacteria are rampant), a different regimen of antibiotics is indicated. Generally, a combination of clindamycin, trimethoprim, and sulfamethoxazole is indicated for these patients, at the same dosages as step 3.

• 5

  For serious infections, especially those in which orbital cellulitis has not been ruled out, a more aggressive course of antibiotics is indicated. This generally involves ampicillin given intravenously. For children, the dose is 50 milligrams per kilogram of body weight every six hours, and for adults the recommended dose is between two and three grams of ampicillin every six hours.