Orbital cellulitis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]; Tarek Nafee, M.D. [3]
Overview
Orbital cellulitis occurs most commonly from typical bacterial infections. In some cases, mycobacteria or mycosis may also be implicated. The most common underlying condition is ethmoid sinusitis, which has been reported in 90-98% of orbital cellulitis cases. The most commonly reported pathogens are Staphylococcus aureus, Streptococcus spp., and Haemophilus influenzae. With the rise of microbial resistance, methicillian-resistant Staphylococcus aureus (MRSA) must be considered as a potential cause and correlated with geographic prevalence. Though some causes may be uncommon, orbital cellulitis is a medical emergency and all etiologies must be considered.[1][2][3][4][5][6]
Causes
Orbital cellulitis occurs most commonly from bacterial infection. In some cases, mycobacterial or fungal infections are observed.[1][2][3][4] Difficulty arises in identifying a specific organism due to challenges in culturing the retroseptal orbital region.[7]
Cause by Pathogen
Common bacterial causes of orbital cellulitis include:[1][2][3]
- Staphylococcus aureus
- Streptococcus spp.
- Haemophilus influenzae
- With the dissemination of Haemophilus influenza type b (Hib) vaccine, the incidence of Haemophilus influenzae-caused orbital cellulitis has decreased significantly.
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Rise in microbial resistance, MRSA must be considered as a potential cause and correlated with geographic prevalence.
- Aerobic and anaerobic bacteria
In immunocompromised patients, additional causes may include:[2]
- Fungal infection
- Mycobacterial infection
Cause by Etiology
Based on etiology, the most common underlying condition causing orbital cellulitis is ethmoid sinusitis, which occurs in 90-98% of cases.[1][5][6] Additional causes based on etiology include:[2][7]
- Sinusitis:
- Dacryocystitis, dacryoadenitis, and other lacrimal duct abnormalities
- Traumatic/Foreign body:
- Spread from superficial infections of the face or adjacent soft tissue:
- Dental caries/Tooth abscess:
- Iatrogenic/post-surgical procedures:
- Immunocompromised patient:
- Diabetic patients with or without history of diabetic ketoacidosis
Cause by Organ System
Causes in Alphabetical Order
- Aeromonas hydrophila
- Anaerobes
- Arcanobacterium
- Aspergillosis
- Aspergillus
- Bacterial rhinosinusitis
- Bacteroides
- Beta-hemolytic streptococci
- Blepharoplasty
- Dacryocystitis
- Dacryocystorhinostomy
- Dental infection
- Eikenella corrodens
- Enterococcus
- Ethmoid sinusitis
- Eyelid surgery
- Foreign body
- Haemophilus influenzae
- Haemophilus parainfluenzae
- Infected mucocele
- Klebsiella pneumoniae
- Moraxella catarrhalis
- MRSA
- MSSA
- Mucor
- Mucorales
- Mucormycosis
- Mycobacterium tuberculosis
- Neisseria gonorrhea
- Ophthalmic surgery
- Orbital decompression
- Orbital fracture
- Osteomyelitis of the orbital bones
- Otitis media
- Peptostreptococcus
- Peribulbar anesthesia
- Phlebitis of the facial veins
- Pseudomonas aeruginosa
- Radial keratotomy
- Retinal surgery
- Rothia mucilaginosa
- Sinusitis
- Staphylococcus aureus
- Strabismus surgery
- Streptococcus
- Streptococcus anginosus
- Streptococcus milleri
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Surgical trauma
- Tooth abscess
- Trauma
- Varicella
References
- ↑ 1.0 1.1 1.2 1.3 Hasanee K, Sharma S (2004). "Ophthaproblem. Orbital cellulitis". Can Fam Physician. 50: 359, 365, 367. PMC 2214559. PMID 15318671.
- ↑ 2.0 2.1 2.2 2.3 2.4 Lam Choi VB, Yuen HK, Biswas J, Yanoff M (2011). "Update in pathological diagnosis of orbital infections and inflammations". Middle East Afr J Ophthalmol. 18 (4): 268–76. doi:10.4103/0974-9233.90127. PMC 3249811. PMID 22224014.
- ↑ 3.0 3.1 3.2 Merck Manual Professional Version (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis
- ↑ 4.0 4.1 American Academy of Ophthalmology Eyewiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Etiology
- ↑ 5.0 5.1 Nageswaran S, Woods CR, Benjamin DK, Givner LB, Shetty AK (2006). "Orbital cellulitis in children". Pediatr Infect Dis J. 25 (8): 695–9. doi:10.1097/01.inf.0000227820.36036.f1. PMID 16874168.
- ↑ 6.0 6.1 Chaudhry IA, Al-Rashed W, Arat YO (2012). "The hot orbit: orbital cellulitis". Middle East Afr J Ophthalmol. 19 (1): 34–42. doi:10.4103/0974-9233.92114. PMC 3277022. PMID 22346113.
- ↑ 7.0 7.1 Baring DE, Hilmi OJ (2011). "An evidence based review of periorbital cellulitis". Clin Otolaryngol. 36 (1): 57–64. doi:10.1111/j.1749-4486.2011.02258.x. PMID 21232022.