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Orbital Conference: Orbital Inflammation

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Title: Orbital Conference: Orbital Inflammation

Authors: Christopher D. Conrady, MD, PhD, Rene Choi, MD, PhD, H. Christian Davidson, MD, and BCK Patel, MD

Date: 06/27/16

Keywords/Main Subjects: orbital cellulitis, infection, inflammation, orbit

Diagnosis/Differential Diagnosis: 2 cases of orbital cellulitis

Brief Description of Case: In the following cases, we present two cases of orbital cellulitis, clinical course, and medical/surgical management.  Both patients presented with eyelid swelling.  The first patient also had motility deficits upon presentation.  They were both found to subsequently have orbital inflammatory events with improvement on IV antibiotics.

Images:

Slide 4: External photograph of patient case 1.

Slide 6-7: CT orbits

Slides 8-12: MRI orbits

Slide 13:  CT orbits

Slide 15-18: Pathology slides showing mild, chronic inflammatory cell reaction.

Slide 19: External photograph of patient

Slide 25-26: External photograph of case 2.

Slide 28-32: CT maxillofacial with contrast

Slide 36-40: Pathology of case 2.

Summary of Cases:

These two cases highlight the medical and surgical management of orbital cellulitis.

References for further reading:

• Ebright et al., “Septic Thrombosis of the Cavernous Sinus.” Arch Intern Med, 2001.
• Garcia et al., “Criteria for Nonsurgical Management of Subperiosteal Abscess of the Orbit.” Ophth, 2000
• Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology 1994; 101:585-595.
• Harris GJ. Subperiosteal abscess of the orbit: computed tomography and the clinical course. Ophthal Plast Reconstr Surg 1996; 12:1-8.Oxford LE, McClay J. Medical and surgical management of subperiosteal orbital abscess secondary to acute sinusitis in children. Int J Pediatr Otorhinolaryngol 2006; 70:1853-1861.
• Harris, “Subperiosteal Abscess of the Orbit: Age as a Factor in the Bacteriology and Response to Treatment”. Ophth, 2014.
• McKinley et al., “Microbiology of Pediatric Orbital Cellulitis.” AJO, 2007.
• Miranda et al., “Brain abscess: Current management. Neuro Rural Prc, 2013.
• Oxford LE, McClay J. Medical and surgical management of subperiosteal orbital abscess secondary to acute sinusitis in children. Int J Pediatr Otorhinolaryngol 2006; 70:1853-1861.
• Segal et al., “Orbital Complications associated with paranasal sinus infections – A 10-year experience in Israel.” Int J Ped Otorhino, 2016.
• Seltz et al., Microbiology and Antibiotic Management of Orbital Cellulitis. Peds, 2011.

Copyright statement: Christopher D. Conrady, ©2016. For further information regarding the rights to this collection, please visit: URL to copyright information page on Moran CORE

**Signed off on by orbital conference faculty attendees