Orbital cellulitis causes: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Orbital cellulitis}} | {{Orbital cellulitis}} | ||
{{CMG}}; {{AE}} {{Ochuko}} {{TarekNafee}} | {{CMG}}; {{AE}} {{Ochuko}}; {{TarekNafee}} | ||
==Overview== | ==Overview== | ||
Orbital cellulitis occurs most commonly from typical [[bacterial infections]]. In some cases, [[Mycobacterium|mycobacteria]] or [[Mycosis|mycosis]] may also be implicated. The most common underlying condition is [[Sinusitis|ethmoid sinusitis]], which has been reported in 90-98% of orbital cellulitis cases. The most commonly reported [[Pathogen|pathogens]] are [[Staphylococcus aureus|''Staphylococcus aureus'']], [[Streptococcus|''Streptococcus spp.'']], and [[Haemophilus influenzae|''Haemophilus influenzae'']]. With the rise of [[Antibiotic resistance|microbial resistance]], [[Methicillin-resistant staphylococcus aureus|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.<ref name="pmid15318671">{{cite journal| author=Hasanee K, Sharma S| title=Ophthaproblem. Orbital cellulitis. | journal=Can Fam Physician | year= 2004 | volume= 50 | issue= | pages= 359, 365, 367 | pmid=15318671 | doi= | pmc=2214559 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15318671 }} </ref><ref name="pmid22224014">{{cite journal| author=Lam Choi VB, Yuen HK, Biswas J, Yanoff M| title=Update in pathological diagnosis of orbital infections and inflammations. | journal=Middle East Afr J Ophthalmol | year= 2011 | volume= 18 | issue= 4 | pages= 268-76 | pmid=22224014 | doi=10.4103/0974-9233.90127 | pmc=3249811 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224014 }} </ref><ref name=merckmanualorbitalcellulitis> Merck Manual Professional Version (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis</ref><ref name=eyewikiorbitalcellulitis> American Academy of Ophthalmology Eyewiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Etiology</ref><ref name="pmid16874168">{{cite journal| author=Nageswaran S, Woods CR, Benjamin DK, Givner LB, Shetty AK| title=Orbital cellulitis in children. | journal=Pediatr Infect Dis J | year= 2006 | volume= 25 | issue= 8 | pages= 695-9 | pmid=16874168 | doi=10.1097/01.inf.0000227820.36036.f1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16874168 }} </ref><ref name="pmid22346113">{{cite journal| author=Chaudhry IA, Al-Rashed W, Arat YO| title=The hot orbit: orbital cellulitis. | journal=Middle East Afr J Ophthalmol | year= 2012 | volume= 19 | issue= 1 | pages= 34-42 | pmid=22346113 | doi=10.4103/0974-9233.92114 | pmc=3277022 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22346113 }} </ref> | |||
==Causes== | ==Causes== | ||
Orbital cellulitis occurs most commonly from bacterial infection. In some cases, | |||
Orbital cellulitis occurs most commonly from [[bacterial infection]]. In some cases, [[mycobacterial]] or [[fungal]] infections are observed.<ref name="pmid15318671">{{cite journal| author=Hasanee K, Sharma S| title=Ophthaproblem. Orbital cellulitis. | journal=Can Fam Physician | year= 2004 | volume= 50 | issue= | pages= 359, 365, 367 | pmid=15318671 | doi= | pmc=2214559 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15318671 }} </ref><ref name="pmid22224014">{{cite journal| author=Lam Choi VB, Yuen HK, Biswas J, Yanoff M| title=Update in pathological diagnosis of orbital infections and inflammations. | journal=Middle East Afr J Ophthalmol | year= 2011 | volume= 18 | issue= 4 | pages= 268-76 | pmid=22224014 | doi=10.4103/0974-9233.90127 | pmc=3249811 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224014 }} </ref><ref name=merckmanualorbitalcellulitis> Merck Manual Professional Version (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis</ref><ref name=eyewikiorbitalcellulitis> American Academy of Ophthalmology Eyewiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Etiology</ref> Difficulty arises in identifying a specific [[organism]] due to challenges in culturing the [[Orbit (anatomy)|retroseptal orbital region]].<ref name="pmid21232022">{{cite journal| author=Baring DE, Hilmi OJ| title=An evidence based review of periorbital cellulitis. | journal=Clin Otolaryngol | year= 2011 | volume= 36 | issue= 1 | pages= 57-64 | pmid=21232022 | doi=10.1111/j.1749-4486.2011.02258.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21232022 }} </ref> | |||
===Cause by Pathogen=== | ===Cause by Pathogen=== | ||
Common [[bacterial]] causes of orbital cellulitis include:<ref name="pmid15318671">{{cite journal| author=Hasanee K, Sharma S| title=Ophthaproblem. Orbital cellulitis. | journal=Can Fam Physician | year= 2004 | volume= 50 | issue= | pages= 359, 365, 367 | pmid=15318671 | doi= | pmc=2214559 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15318671 }} </ref><ref name="pmid22224014">{{cite journal| author=Lam Choi VB, Yuen HK, Biswas J, Yanoff M| title=Update in pathological diagnosis of orbital infections and inflammations. | journal=Middle East Afr J Ophthalmol | year= 2011 | volume= 18 | issue= 4 | pages= 268-76 | pmid=22224014 | doi=10.4103/0974-9233.90127 | pmc=3249811 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224014 }} </ref><ref name=merckmanualorbitalcellulitis> Merck Manual Professional Version (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis</ref> | |||
*''[[Staphylococcus aureus]]'' | |||
*''[[Streptococcus|Streptococcus spp.]]'' | |||
*''[[Haemophilus influenzae]]'' | |||
** With the dissemination of [[Haemophilus influenzae Type b (Hib) Vaccine (patient information)|Haemophilus influenza type b (Hib) vaccine]], the [[incidence]] of [[Haemophilus influenzae|''Haemophilus influenzae'']]-caused orbital cellulitis has decreased significantly. | |||
*[[Methicillin-resistant staphylococcus aureus|Methicillin-resistant ''Staphylococcus aureus'' (MRSA)]] | |||
**Rise in [[Antibiotic resistance|microbial resistance]], [[Methicillin-resistant staphylococcus aureus|MRSA]] must be considered as a potential cause and correlated with geographic [[prevalence]]. | |||
*[[Aerobic organism|Aerobic]] and [[Anaerobic organism|anaerobic bacteria]] | |||
In [[Immunodeficiency|immunocompromised]] patients, additional causes may include:<ref name="pmid22224014">{{cite journal| author=Lam Choi VB, Yuen HK, Biswas J, Yanoff M| title=Update in pathological diagnosis of orbital infections and inflammations. | journal=Middle East Afr J Ophthalmol | year= 2011 | volume= 18 | issue= 4 | pages= 268-76 | pmid=22224014 | doi=10.4103/0974-9233.90127 | pmc=3249811 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224014 }} </ref> | |||
*[[Mycosis|Fungal]] infection | |||
**[[Zygomycosis|Mucormycosis]] | |||
**[[Aspergillosis|Aspergilliosis]] | |||
*[[Mycobacterium|Mycobacterial]] infection | |||
**''[[Mycobacterium tuberculosis]]'' | |||
===Cause by Etiology=== | ===Cause by Etiology=== | ||
Based on [[etiology]], the most common underlying condition causing orbital cellulitis is [[Sinusitis|ethmoid sinusitis]], which occurs in 90-98% of cases.<ref name="pmid15318671">{{cite journal| author=Hasanee K, Sharma S| title=Ophthaproblem. Orbital cellulitis. | journal=Can Fam Physician | year= 2004 | volume= 50 | issue= | pages= 359, 365, 367 | pmid=15318671 | doi= | pmc=2214559 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15318671 }} </ref><ref name="pmid16874168">{{cite journal| author=Nageswaran S, Woods CR, Benjamin DK, Givner LB, Shetty AK| title=Orbital cellulitis in children. | journal=Pediatr Infect Dis J | year= 2006 | volume= 25 | issue= 8 | pages= 695-9 | pmid=16874168 | doi=10.1097/01.inf.0000227820.36036.f1 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16874168 }} </ref><ref name="pmid22346113">{{cite journal| author=Chaudhry IA, Al-Rashed W, Arat YO| title=The hot orbit: orbital cellulitis. | journal=Middle East Afr J Ophthalmol | year= 2012 | volume= 19 | issue= 1 | pages= 34-42 | pmid=22346113 | doi=10.4103/0974-9233.92114 | pmc=3277022 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22346113 }} </ref> Additional causes based on etiology include:<ref name="pmid22224014">{{cite journal| author=Lam Choi VB, Yuen HK, Biswas J, Yanoff M| title=Update in pathological diagnosis of orbital infections and inflammations. | journal=Middle East Afr J Ophthalmol | year= 2011 | volume= 18 | issue= 4 | pages= 268-76 | pmid=22224014 | doi=10.4103/0974-9233.90127 | pmc=3249811 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22224014 }} </ref><ref name="pmid21232022">{{cite journal| author=Baring DE, Hilmi OJ| title=An evidence based review of periorbital cellulitis. | journal=Clin Otolaryngol | year= 2011 | volume= 36 | issue= 1 | pages= 57-64 | pmid=21232022 | doi=10.1111/j.1749-4486.2011.02258.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21232022 }} </ref> | |||
*'''[[Sinusitis]]''': | |||
**[[Staphylococcus aureus|''Staphylococcus aureus'']] | |||
**[[Streptococcus|''Streptococcus spp.'']] | |||
**[[Haemophilus influenzae|''Haemophilus influenzae'']] | |||
*'''[[Dacryocystitis]], [[dacryoadenitis]], and other [[lacrimal duct]] abnormalities''' | |||
**[[Staphylococcus aureus|''Staphylococcus aureus'']] | |||
**[[Streptococcus pneumoniae|''Streptococcus pneumoniae'']] | |||
**[[Streptococcus pyogenes|''Streptococcus pyogenes'']] | |||
**[[Haemophilus influenzae|''Haemophilus influenzae'']] | |||
*'''Traumatic/[[Foreign body|Foreign body]]''': | |||
**[[Staphylococcus aureus|''Staphylococcus aureus'']] | |||
**[[Staphylococcus epidermidis|''Staphylococcus epidermidis'']] | |||
**[[Enterococcus|Enterococcus spp.]] | |||
**[[Escherichia coli|''Escherichia coli'']] | |||
**[[Eikenella|''Eikenella spp.'']] | |||
*'''Spread from superficial [[infections]] of the face or adjacent [[soft tissue]]''': | |||
**[[Staphylococcus aureus|''Staphylococcus aureus'']] | |||
**[[Streptococcus pyogenes|''Streptococcus pyogenes'']] | |||
*'''[[Dental caries|Dental caries]]/[[Tooth abscess|Tooth abscess]]''': | |||
**[[Bacteroides|''Bacteroides spp.'']] | |||
**[[Anaerobic organism|anaerobes]] | |||
**[[Gram-negative bacteria|gram negative]] rods | |||
*'''Iatrogenic/post-surgical procedures''': | |||
**[[Staphylococcus aureus|''Staphylococcus aureus'']] | |||
**[[Streptococcus|''Streptococcus spp.'']] | |||
*'''[[Immunocompromised]] patient''': | |||
**[[Zygomycosis|''Mucormycosis'']] | |||
**''[[Aspergillosis|Aspergilliosis]]'' | |||
**''[[Mycobacterium tuberculosis]]'' | |||
*'''[[Diabetic]] patients with or without history of [[diabetic ketoacidosis]]''' | |||
**[[Pseudomonas aeruginosa|''Pseudomonas aeruginosa'']] | |||
**[[Klebsiella pneumoniae|''Klebsiella pneumoniae'']] | |||
===Cause by Organ System=== | ===Cause by Organ System=== | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Ophthalmologic''' | | '''Ophthalmologic''' | ||
|bgcolor="Beige"| [[Blepharoplasty]], [[dacryocystitis]], [[dacryocystorhinostomy]], [[blepharoplasty|eyelid surgery]], [[eye surgery|ophthalmic surgery]], | |bgcolor="Beige"| [[Blepharoplasty]], [[dacryocystitis]], [[dacryocystorhinostomy]], [[blepharoplasty|eyelid surgery]], [[eye surgery|ophthalmic surgery]], orbital decompression, [[blowout fracture|orbital fracture]], [[osteomyelitis|osteomyelitis of the orbital bones]], [[radial keratotomy]], [[eye surgery|retinal surgery]], [[strabismus surgery]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{columns-list | {{columns-list| | ||
*[[Aeromonas hydrophila]] | *[[Aeromonas hydrophila]] | ||
*[[Anaerobes]] | *[[Anaerobes]] | ||
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{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
Latest revision as of 23:26, 29 July 2020
Orbital cellulitis Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Orbital cellulitis causes On the Web |
American Roentgen Ray Society Images of Orbital cellulitis causes |
Risk calculators and risk factors for Orbital cellulitis causes |
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.