Periorbital Cellulitis In Children

What is periorbital cellulitis?

Periorbital cellulitis is an infection in and under the skin around the eye. It is also called preseptal cellulitis. The infection is caused by germs called bacteria. Periorbital cellulitis is most common in children under age 6.

What increases my child's risk for periorbital cellulitis?

• A sinus infection or a respiratory infection, such as a cold.
  
  
• Cuts, scratches, or bites that break the skin. Even tiny breaks in the skin from insect bites can cause an infection.
  
  
• Deep tooth infections.
  
  
• Styes (eyelid bumps) or swelling of the gland that makes tears.

What are the signs and symptoms of periorbital cellulitis?

Your child may have any of the following:

• Redness and swelling around his eye and on his eyelid. The area may be warm and tender (painful to the touch).
  
  
• Problems opening his eye.
  
  
• Fever.
  
  
• Pain and drainage from his eye. You may see red streaks on the skin around his eye.

How is periorbital cellulitis diagnosed?

Your child’s caregiver will examine your child's eye and the swelling around it. He will ask when your child's symptoms began. He may gently push back your child’s eyelid to check for infection around the eye. He may also check your child's vision. Tell your child's caregiver if your child has had a recent sinus infection, past eye surgery, or dental problems. Your child may also need the following tests:

• Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, or heel. Blood tests can give caregivers more information about your child's health. Blood tests may show what bacteria caused your child's infection so caregivers can better treat him.
  
  
• Drainage culture: Your child’s caregiver collects drainage from your child's eye to learn which germs have caused the infection.
  
  
• Computed tomography scan: This is also called a CT scan. A CT takes pictures of your child’s bones, muscles, and blood vessels around his eyes. Dye may be used to help the pictures show up better. Your child may swallow the dye, or he may get it through an IV. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to the dye. Tell your child's caregiver if your child is allergic to shellfish.

How is periorbital cellulitis treated?

With treatment, periorbital cellulitis usually goes away within 2 weeks. Your child may need any of the following:

• Antibiotics: This medicine will help fight or prevent an infection. Make sure your child takes his antibiotics until they are gone, even if he feels better.
  
  
• Ibuprofen or acetaminophen: These medicines are available without a prescription. They may decrease your child’s pain and fever. Ask how much medicine your child needs and how to give it.
  
  
• Tetanus vaccine: This medicine prevents tetanus. It is given as a shot. Tetanus is a life-threatening infection your child can get through deep cuts or puncture wounds. Ask your child’s caregiver which vaccines your child needs and when he should get them.
  
  
• Warm, moist compresses: A warm, damp cloth put over your child's eye can help soothe the area.

What are the risks of periorbital cellulitis?

Without treatment, the infection can spread to other parts of your child’s body. Your child may need to stay in the hospital to treat these infections. Infections that spread to the eye can lead to vision loss. Infections that spread to the brain can be life-threatening.

How do I prevent periorbital cellulitis?

• Have your child wear proper safety equipment to protect his face from injury during sports and other activities.
  
  
• Keep wounds clean and dry. Clean wounds on the face with soap and water. Cover wounds with a dry bandage. Use topical antibiotic ointment on skin breaks to help prevent infection.
  
  
• Have your child’s caregiver check animal bites and deep wounds right away.

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child does not feel better, or his symptoms do not improve in 1 to 2 days.
  
  
• You see red streaks on the skin of the infected area.
  
  
• Your child’s eye becomes more painful and red.
  
  
• You see pus or other fluid coming from your child’s eye.
  
  
• You have questions about your child’s condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your child has blurred or double vision and cannot see well in bright light.
  
  
• Your child's infected eye is bulging from his head.
  
  
• Your child has a high fever and chills.
  
  
• Your child is more sleepy than usual or is hard to wake.
  
  
• Your child says his neck feels stiff. He may have a headache, and he may vomit.
  
  
• Your child has a seizure.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.