Orbit/Oculoplastic Quiz 3: Infection
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Figure 1
Figures 1-2. 54 year old man with 4 days of progressively worsening pain and swelling around the right eye. |
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Figure 2
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Questions and Answers | |
1. What is the differential diagnosis? Answer: Preseptal cellulitis, orbital cellulitis, pseudotumor, malignancy, trauma. 2. What is the classification scheme for orbital infectious processes? Answer: A) Preseptal cellulitis. B)Orbital cellulitis. C) Subperiosteal abscess. D)Orbital abscess. E)Cavernous sinus thrombosis. Note: these are independent categories and do not necessarily represent chain of progression of disease. 3. In what age GROUP is preseptal cellulitis most commonly seen? Answer: Pediatric. A vast majority of patients (around 80%) are less than 20 years old. 4. What diagnostic modalitis are indicated in the work-up of the above pictured patient? Answer: Complete ophthalmic examination, including cranial nerve testing, color vision testing and ocular motility testing. Additionally; CT scanning, blood cultures and wound cultures should be obtained. Lumbar puncture may be required if meningeal signs are present. 5. How should this patient be treated? Answer: Broad-spectrum intravenous antibiotics are indicated in such severe cases. Oral antibiotics may suffice in less severe infections. Abscesses require surgical drainage for complete resolution. | |
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