Preseptal cellulitis
Although preseptal cellulitis usually improves quickly once treatment has started, it is a disease that can be very uncomfortable for the patient.
Therefore, it is important to diagnose and treat it as soon as possible, and from that moment it does not usually involve any complications.
Preseptal cellulitis
Although preseptal cellulitis usually improves quickly once treatment has started, it is a disease that can be very uncomfortable for the patient.
Therefore, it is important to diagnose and treat it as soon as possible, and from that moment it does not usually involve any complications.
What is preseptal cellulite?
Preseptal cellulite is a soft tissue infection anterior to the orbital septum, which is a fibrous sheet located between the bones of the orbit and the eyelids. It is more common than postseptal cellulitis, and usually occurs in children under 5 years of age.
To prevent it is important maintain proper hygiene habits, which should include frequent handwashing after eyelid injury.
In both the case of preseptal cellulitis and postseptal cellulite, a correct vaccination it can also serve as a preventive measure in some cases.
Differences between preseptal and postseptal cellulitis
In the case of preseptal or periorbital cellulitis the eye becomes inflamed, just as if it were a orzuelo but that affects the entire periocular area of the eye.
Your symptoms may appear after infection or localized injury, such as a sting or trauma. In patients under 3 years it may be caused by a blood infection.
La postseptal cellulitis is generated behind the septum, and it is common for it to cause damage to the extraocular muscles, optic nerve, etc.
Presents itself after an infection near the eyes, especially of the paranasal sinuses, in less cases, after a dental or ear infection.
There is a possibility that affect eye movements, causing the orbit to move forward. Furthermore, it is common for a decreased vision.
Diagnosis of anterior septal cellulitis it is usually clinical, and complementary tests are not usually required.
Instead, in the orbital cellulitis an image test must be performed, being more common the computed tomography. This is done to confirm the suspicion and assess whether there is a risk of complications.
Another important difference is that preseptal cellulitis has no risk of complications, and usually improves quickly once treatment begins.
La orbital cellulitis is more serious, since it affects vision to a greater extent, forming abscesses, and causing generalized infection and meningitis.
Symptom
Patients with a periorbital cellulite they may have the following symptoms:
- Inflammation in the tissues around the eye, which are hot, red and painful to touch.
- The eyelid sometimes cannot be opened easily, because of a great inflammation. Once it is opened, neither eye movements nor vision are affected.
- Fever.
- Edema.
- Atypical color on the eyelid.
Transmission
Treatment of preseptal cellulitis consists of taking antibiotics by mouth.
In cases where the patient suffers from a severe infection, or where for some reason they cannot take oral antibiotics, they should opt for hospitalize and administer intravenous antibiotics, always under the supervision of an ophthalmologist.
You can perform a Outpatient treatment once orbital cellulite has been definitively ruled out. For this, it is necessary that children do not present no signs of systemic infectionand left in the care of their parents or guardians.
Among the options for outpatient treatment, which must be rigorously controlled by the ophthalmologist, are the following:
- Amoxicillin/Clavulanate 30 mg/kg orally every 8 hours (in the case of children under 12 years of age).
- 500 mg orally 3 times a day, or 875 mg orally 2 times a day for 10 days (treatment indicated for adults).
If the patient is hospitalized, a possible treatment would consist of:
- Ampicillin / sulbactam 50 mg / kg IV every 6 hours, if it is children.
- 1,5-3 g IV every 6 hours, if the patient is an adult. The maximum dose would be 8 g per day of ampicillin for 7 days.
Possible complications of preseptal cellulitis
Preseptal cellulite is a benign condition, and usually improves after 24 to 48 hours of oral antibiotic treatment (Although this should continue for a week or 10 days, as antibiotics cannot be stopped before this time).
In this case, the patient should go to the ophthalmological consultation as soon as possible if you have the following symptoms:
- Great inflammation in the eyelid, especially visible, painful and hot.
- Vision disturbance, problems when moving the eye, or movement forward.
- Lack of improvement after 24 to 48 hours of oral antibiotic treatment.
