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Preseptal Cellulitis

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61. Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

secondary to congestion within the ethmoid sinuses. Alternative terms for sympathetic effusion (inflammatory edema) are preseptal or periorbital cellulitis. The remaining “true” orbital complications are best visualized by contrast-enhanced CT scanning. Intracranial complications of acute sinusitis, which are substantially less common than orbital complications, are more serious, with higher morbidity and mortality than those involving the orbit. Intracranial complications should be suspected (...) , especially if accompanied by proptosis or impaired function of the extraocular muscles. Orbital complications of acute sinusitis have been divided into 5 categories: sympathetic effusion, subperiosteal abscess, orbital cellulitis, orbital abscess, and cavernous sinus thrombosis. Although sympathetic effusion (inflammatory edema) is categorized as an orbital complication, the site of infection remains confined to the sinus cavities; eye swelling is attributable to the impedance of venous drainage

2013 American Academy of Pediatrics

62. Periorbital Dirofilariasis: A Rare Case from Western India (PubMed)

Periorbital Dirofilariasis: A Rare Case from Western India Dirofilariasis is a zoonotic disease caused commonly by Dirofilaria repens and Dirofilaria immitus. The definitive hosts are domestic dogs and cats. Human beings are accidental dead end hosts, and acquire infestation through mosquito bites. So far, very few cases have been reported from western India. We report a case of a 27-year-old male who presented with preseptal cellulitis right eye and a firm mass in the lower lid (...) . Histopathological examination after surgical excision of the mass revealed a diagnosis of dirofilariasis. Although rare in Western India a diagnosis of dirofilariasis should be considered in cases of preseptal cellulitis associated with a periorbital mass.

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2016 Journal of clinical and diagnostic research : JCDR

63. Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis. (PubMed)

Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis. Hereditary angioedema is an autosomal dominant and life-threatening disorder characterized by recurrent episodes of non-pitting edema affecting the skin, respiratory system and digestive tracts and caused by a congenital deficiency or function defect of the C1 esterase inhibitor. Preseptal cellulitis is defined as an infection of the tissues of the anterior orbital septum. It is generally caused

2016 International Journal of Pediatric Otorhinolaryngology

64. Hospital cost of pediatric patients with complicated acute sinusitis. (PubMed)

of stay, type of complication and cost of care were determined for these patients.The study included 64 patients with a mean age of 10 years. Orbital cellulitis (orbital/preseptal/postseptal cellulitis) accounted for 32.8% of patients, intracranial complications (epidural/subdural abscess, cavernous sinus thrombosis) for 29.7%, orbital abscesses (subperiosteal/intraorbital abscesses) for 25.0%, potts puffy tumor for 7.8%, and other (including facial abscess and dacryocystitis) for 4.7%. The average

2016 International Journal of Pediatric Otorhinolaryngology

65. Styes (hordeola)

, individuals providing feedback on published topics, and Editorial Steering Group members. Declarations of interest are completed annually for authoring team and editorial steering group members, and are completed at the start of the topic update and development process for external stakeholders. Competing interests declared for this topic: None. References References Benton,J. and Karkanevatos,A. ( 2007 ) Preseptal cellulitis due to Mycobacterium marinum. Journal of Laryngology & Otology. 121 ( 6 ), 606 (...) of the eyelid, caused by infection of an eyelash follicle or associated gland, or Internal — occurs on the conjunctival surface of the eyelid, caused by infection of a meibomian gland. Styes are generally self-limiting, and most resolve within 5–7 days. Styes are common in people with blepharitis and recurrence is common if any underlying blepharitis is not adequately managed. Rarely, infection may spread to neighbouring tissues, which can lead to periorbital cellulitis. A persistent internal stye can

2015 NICE Clinical Knowledge Summaries

66. Histopathologic features in a case of hyperimmunoglobulinemia D syndrome (PubMed)

Histopathologic features in a case of hyperimmunoglobulinemia D syndrome We describe a case of Mevalonate Kinase Deficiency (MKD) also known as Hyperimmunoglobulinemia D Syndrome (HIDS) presenting as a Sweet-like syndrome in a 5-week-old with multiple erythematous plaques, fever, aseptic meningitis, and bronchiolitis. The locations of the predominant plaques were periumbilical and periocular, which originally prompted concern for omphalitis and preseptal cellulitis. Histopathology demonstrated

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2015 Indian dermatology online journal

67. Les cellulites orbitaires: étude prospective à propos de 75 cas (PubMed)

preseptal cellulitis retroseptal cellulitis sinusitis 2015 06 15 2015 09 10 2016 3 16 6 0 2015 1 1 0 0 2016 12 15 6 0 epublish 26977247 10.11604/pamj.2015.22.340.7279 PAMJ-22-340 PMC4773059 Ear Nose Throat J. 2002 Nov;81(11):771-5 12472030 Laryngoscope. 1970 Sep;80(9):1414-28 5470225 Laryngoscope. 1982 Jul;92(7 Pt 1):729-31 7087639 Radiology. 1985 Sep;156(3):715-6 4023231 J Radiol. 2008 Jun;89(6):803-5 18641568 Pediatr Infect Dis J. 1987 Apr;6(4):404-10 3455657 Arch Pediatr. 1994 Oct;1(10):879-85 (...) Les cellulites orbitaires: étude prospective à propos de 75 cas 26977247 2016 12 13 2018 11 13 1937-8688 22 2015 The Pan African medical journal Pan Afr Med J [Orbital cellulitis: prospective study about 75 cases]. 340 10.11604/pamj.2015.22.340.7279 Belghmaidi Sarah S Service d'Ophtalmologie, CHU Mohammed VI, Marrakech, Maroc. Belhoucha Btissam B Service d'Orl et Chirurgie Cervico-Faciale, CHU Mohammed VI, Marrakech, Maroc. Hajji Ibtissam I Service d'Ophtalmologie, CHU Mohammed VI, Marrakech

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2015 The Pan African medical journal

68. Transnasal Endoscopic Treatment of Orbital Complications of Acute Sinusitis: The Graz Concept. (PubMed)

of General Otorhinolaryngology of the ENT-University Hospital Graz from 2000 to 2011.Of 53 patients, men were affected more frequently than women (n=37, 69.81% vs n=16, 30.19%). The following diagnoses were obtained: 9 preseptal cellulitis, 7 orbital cellulitis, 14 subperiosteal abscesses, and 23 orbital abscesses. In 16 patients, a conservative therapy was administered; 37 patients underwent surgery, most of them purely endoscopically (n=31, 83.78%). Two of the patients who underwent conservative

2014 Rhinology and Laryngology

69. Rhinosinusitis in children: A comparison of patients requiring surgery for acute complications versus chronic disease. (PubMed)

allergies, prior sinusitis, prior nasal steroid use, or adenoidectomy (p<0.05). In addition, they had more frequent involvement of ethmoid and frontal sinuses (p<0.05). The most common cultures results were no growth (30.8%), Streptococcus milleri (30.8%), and normal flora (19.2%) in ABS for the with a complication group, and normal flora (41.5%), coagulase negative Staphylococcus (22%), and Propionobacterium (19.5%) for the CRS group. Most prevalent complications were preseptal cellulitis (55.5

2014 American Journal of Otolaryngology

70. Conjunctivitis - allergic

causes of red eye, some of which are serious or sight-threatening and require same day assessment by ophthalmology — for further information, see the CKS topic on . The differential diagnosis for allergic conjunctivitis includes: Serious conditions such as: Acute glaucoma. Episcleritis and scleritis. Keratitis. Iritis/uveitis. Corneal ulcer, abrasion or foreign body. Preseptal or preorbital cellulitis. Other types of conjunctivitis such as: Infective conjunctivitis — may be caused by viruses (...) ) looking for asymmetric or unreactive pupils. Visual acuity (using a Snellen chart) and visual fields. Compare to previous levels of visual acuity, if possible. Eyelids – look for discharge, swelling, inflammation, malposition, nodules, loss of lashes (may indicate sebaceous gland carcinoma), vesicles (herpes), lice infestation or blepharitis. Periorbital area — look for swelling and erythema which may indicate orbital or periorbital cellulitis. Periorbital cellulitis can develop from conjunctivitis

2012 NICE Clinical Knowledge Summaries

71. Tuberculosis (Diagnosis)

. Adnexal or orbital disease may be seen with preauricular lymphadenopathy. Because of the wide variability in the disease process, presenting complaints will vary. Most often, patients will complain of blurry vision that may or may not be associated with pain and red eye. In the rare case of orbital disease, proptosis, double vision, or extraocular muscle motility restriction may be the presenting complaint. Preseptal cellulitis in children with spontaneous draining fistula may also occur. In cases

2014 eMedicine.com

72. Tuberculosis (Diagnosis)

. Adnexal or orbital disease may be seen with preauricular lymphadenopathy. Because of the wide variability in the disease process, presenting complaints will vary. Most often, patients will complain of blurry vision that may or may not be associated with pain and red eye. In the rare case of orbital disease, proptosis, double vision, or extraocular muscle motility restriction may be the presenting complaint. Preseptal cellulitis in children with spontaneous draining fistula may also occur. In cases

2014 eMedicine.com

73. Tuberculosis (Overview)

. Adnexal or orbital disease may be seen with preauricular lymphadenopathy. Because of the wide variability in the disease process, presenting complaints will vary. Most often, patients will complain of blurry vision that may or may not be associated with pain and red eye. In the rare case of orbital disease, proptosis, double vision, or extraocular muscle motility restriction may be the presenting complaint. Preseptal cellulitis in children with spontaneous draining fistula may also occur. In cases

2014 eMedicine.com

74. Tuberculosis (Overview)

. Adnexal or orbital disease may be seen with preauricular lymphadenopathy. Because of the wide variability in the disease process, presenting complaints will vary. Most often, patients will complain of blurry vision that may or may not be associated with pain and red eye. In the rare case of orbital disease, proptosis, double vision, or extraocular muscle motility restriction may be the presenting complaint. Preseptal cellulitis in children with spontaneous draining fistula may also occur. In cases

2014 eMedicine.com

75. Haemophilus Influenzae Infection (Diagnosis)

, Neisseria meningitidis, and Streptococcus pneumoniae in children in England over five decades: a population-based observational study. Lancet Infect Dis . 2014 May. 14(5):397-405. . Friesen CA, Cho CT. Characteristic features of neonatal sepsis due to Haemophilus influenzae. Rev Infect Dis . 1977. 8:777. . Lessner A, Stern GA. Preseptal and orbital cellulitis. Infect Dis Clin North Am . 1992 Dec. 6(4):933-52. . Kroger AT, Sumaya CV, Pickering LK, Atkinson WL. General recommendations on immunization (...) . The unencapsulated strains were chiefly responsible for infections at mucosal surfaces, including , conjunctivitis, , and . In contrast, one of the 6 antigenically distinct encapsulated strains, strain type b, was associated with invasive diseases (eg, septicemia, meningitis, cellulitis, septic , epiglottitis, ). Prior to the availability of an effective vaccine, H influenzae type b (Hib) was the most common cause of pediatric bacterial meningitis in the United States. Next: Pathophysiology Pathogenesis A major

2014 eMedicine Pediatrics

76. Pediatric Sinusitis, Medical Treatment

these children is to combine antibiotic therapy with treatment of associated conditions for a time sufficient to allow resolution of symptoms with return of normal sinus physiology and mucociliary clearance. This article addresses the medical management of pediatric sinusitis. See the image below. Preseptal cellulitis of the left eye. Courtesy of Dwight Jones, MD. Diagnosis and management Laboratory tests are normally not particularly helpful in making the diagnosis of sinusitis. However, they can (...) . . Venekamp RP, Thompson MJ, Hayward G, et al. Systemic corticosteroids for acute sinusitis. Cochrane Database Syst Rev . 2014 Mar 25. 3:CD008115. . Brook I. The role of antibiotics in pediatric chronic rhinosinusitis. Laryngoscope Investig Otolaryngol . 2017 Jun. 2 (3):104-8. . . Media Gallery Preseptal cellulitis of the left eye. Courtesy of Dwight Jones, MD. Axial CT scan of subperiosteal abscess of the left eye. Coronal CT scan of subperiosteal abscess of the left eye. Coronal CT scan of superior

2014 eMedicine Surgery

77. Sinusitis, Chronic (Follow-up)

to an otolaryngologist when they manifest any of these signs and/or symptoms: double or reduced vision, proptosis, rapidly developing periorbital edema, ophthalmoplegia, focal neurologic signs, high fever, severe headache, meningeal irritation, or significant or recurrent nose bleeding. [ ] Orbital complications include preseptal cellulitis, subperiosteal abscess, orbital cellulitis, orbital abscess, and cavernous sinus thrombosis. Intracranial complications include meningitis, epidural abscess, subdural abscess (...) is new and where next?. J Laryngol Otol . 2015 Aug. 129 (8):744-51. . Nayak N, Satpathy G, Prasad S, Thakar A, Chandra M, Nag TC. Clinical implications of microbial biofilms in chronic rhinosinusitis and orbital cellulitis. BMC Ophthalmol . 2016 Sep 21. 16 (1):165. . Brook I, Foote PA, Hausfeld JN. Increase in the frequency of recovery of meticillin-resistant Staphylococcus aureus in acute and chronic maxillary sinusitis. J Med Microbiol . 2008 Aug. 57:1015-7. . Brook I. Acute and chronic bacterial

2014 eMedicine.com

78. Sinusitis, Acute (Follow-up)

ophthalmological evaluation and appropriate radiological studies. CT scanning is the most sensitive means of diagnosing an orbital abscess, although ultrasound has been found to be 90% effective for diagnosing anterior abscesses. [ ] The classification by Chandler, which is based on physical examination findings, provides a reasonable framework to guide management. This classification consists of 5 groups of orbital inflammation [ ] : Group 1 - Inflammatory edema (preseptal cellulitis) with normal visual (...) acuity and extraocular movement Group 2 - Orbital cellulitis with diffuse orbital edema but no discrete abscess Group 3 - Subperiosteal abscess beneath the periosteum of the lamina papyracea resulting in downward and lateral globe displacement Group 4 - Orbital abscess with chemosis, ophthalmoplegia, and decreased visual acuity Group 5 - Cavernous sinus thrombosis with rapidly progressive bilateral chemosis, ophthalmoplegia, retinal engorgement, and loss of visual acuity; possible meningeal signs

2014 eMedicine.com

79. Dacryocystitis (Diagnosis)

caused by a systemic disease. The primary morbidity is associated with chronic tearing, mattering, and conjunctival inflammation and infection. Congenital dacryocystitis is a very serious disease associated with significant morbidity and mortality. If not treated promptly and aggressively, newborn infants can experience orbital cellulitis (because the orbital septum is formed poorly in infants), brain abscess, meningitis, sepsis, and death. Congenital dacryocystitis can be associated (...) and preseptal orbicularis muscles. Anteriorly, the medial canthal tendon covers the upper two fifths of the lacrimal sac. The nasolacrimal duct averages 18 mm in length and 4.5-5 mm in diameter. Multiple valves are present in the nasolacrimal duct, representing analog from the segmental canalization of the ectodermal cord that develops into the nasolacrimal duct. Of these, the most prominent valves are the valve of Taillefer, the valve of Krause, and the valve of Hasner (located at the junction of the duct

2014 eMedicine.com

80. Cutaneous Tuberculosis (Diagnosis)

. Adnexal or orbital disease may be seen with preauricular lymphadenopathy. Because of the wide variability in the disease process, presenting complaints will vary. Most often, patients will complain of blurry vision that may or may not be associated with pain and red eye. In the rare case of orbital disease, proptosis, double vision, or extraocular muscle motility restriction may be the presenting complaint. Preseptal cellulitis in children with spontaneous draining fistula may also occur. In cases

2014 eMedicine.com

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