Postseptal cellulitis
La postseptal cellulitis it is an infection that can affect the internal components of the eye socket. It is important to learn to identify it, since your symptoms can be very bothersome, and in some cases can present serious complications. Making a timely diagnosis will be key to applying the appropriate treatment and successfully curing this condition.
La postseptal cellulitis it is an infection that can affect the internal components of the eye socket. It is important to learn to identify it, since your symptoms can be very bothersome, and in some cases can present serious complications. Making a timely diagnosis will be key to applying the appropriate treatment and successfully curing this condition.
What is postseptal cellulite?
La postseptal cellulitis or orbital cellulitis It is the infection of the orbital tissues that are behind the orbital septum.
Usually the doctor can recognize it by a clinical diagnosis, although there are cases in which tests such as a CT scan (TC) or a nuclear magnetic resonance (NMR).
Differences with preseptal
One of the main differences between postseptal and preseptal cellulite is its location.
In the case of the preseptal cellulitis or periorbital inflammation is limited to tissues anterior to the septum or orbital septum. Instead, in the postseptal cellulitis said inflammation affects the content of the orbit, that is to say, the fat and the orbital muscles.
Furthermore, the preseptal cellulitis is usually due to contiguous propagation of trauma on the local face or eyelid, conjunctivitis, insect bites, animal bites and chalazion. On the other hand, the appearance of the postseptal usually has an infectious origin.
Causes
Orbital cellulite can be caused mainly by:
- Un external infectious focus, like a wound.
- Infections that extend from the teeth or sinuses.
- Metastatic spread of infections located in other parts of the body.
Symptom
The main symptoms that can be presented in the postseptal cellulitis are the following:
- Conjunctival hyperemia and chemosis.
- Redness in the eyelid and surrounding soft tissues.
- Difficulty moving the eye.
- Pain when moving the eye.
- Lower visual acuity.
- Exophthalmia caused by orbital edema.
There are other less common but equally important symptoms such as:
- Signs of primary infection, such as sinus bleeding, nasal discharge, edema with abscess, and periodontal pain.
- Fever
In case it occurs headache and drowsiness, consider the possibility that there is a associated meningitis.
Treatment of postseptal cellulite
The patient with postseptal cellulitis caused by meningitis should be admitted and dealt with dosed antibiotics for meningitis. If there is sinusitis, you can opt for a cephalosporin second or third generation.
When orbital cellulitis is associated with foreign bodies or trauma, the treatment has to cover bacteria grampositive, and continue for 1 to 10 days or until clinical improvement is observed.
Antibiotic treatment should start as soon as possibleeven before the results of laboratory tests are known. The medication used initially can be changed if the results of the culture so advise.
- Suspicion of foreign body or suppuration.
- Vision risk.
- When imaging shows large subperiosteal or orbital abscesses, particularly in the orbital roof.
- If the infection does not improve with antibiotic treatment.
Possible complications of postseptal cellulitis
In general, there are no complications in the treatment and the patient usually presents a correct evolution when appropriate treatment is applied.
However, in the case of postseptal cellulite some complications may occur that worsen the prognosis, and that can lead to reduced visual acuity:
- Subperiosteal abscess: usually occurs in the medial area of the orbit, and is the most common complication in postseptal cellulitis.
- Orbital abscess: in this case proptosis, pain with eye movements and ophthalmoplegia are usually more severe.
- Extraorbital extension: consists of a condition of the orbital apex that makes the reduction of visual acuity more severe, meningitis, brain abscess or thrombosis cavernous sinus septic. If a bilateral proptosis is present, it is possible to think that there is an extraorbital extension.
