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. By far, the most common underlying condition is ethmoid sinusitis. It has been reported as the cause in 90-98% of orbital cellulitis cases. Thus, the most commonly reported pathogens were Staphylococcus aureus, Streptococcus spp., and Haemophilus influenzae. With the rise of microbial resistance in more recent years, 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. Thus, it is pertinent to consider all possible etiologies and the most common pathogens according to the clinical scenario.[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 pathogenic, 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 in recent years. 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
- Mucormycosis
- Aspergilliosis
- 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: Staphylococcus aureus, Streptococcus spp., Haemophilus influenzae
- Dacryocystitis, dacryoadenitis, and other lacrimal duct abnormalities: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae
- Traumatic/Foreign body: Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus spp., Escherichia coli, Eikenella spp.
- Spread from superficial infections of the face or adjacent soft tissue: Staphylococcus aureus, Streptococcus pyogenes
- Dental caries/Tooth abscess: Bacteroides spp. anaerobes, and gram negative rods
- Iatrogenic/post-surgical procedures: Staphylococcus aureus, Streptococcus spp.
- Immunocompromised patient: Mucormycosis, Aspergilliosis, Mycobacterium tuberculosis
- Diabetic patients with or without history of diabetic ketoacidosis: Pseudomonas aeruginosa, Klebsiella pneumoniae
Cause by Organ System
Causes in Alphabetical Order
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.