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Periorbital Cellulitis in Children


What is periorbital cellulitis?

Periorbital cellulitis is inflammation and infection of one or both eyelids caused by bacteria. Periorbital cellulitis is most common in children younger than 5 years old.

What increases my child's risk for periorbital cellulitis?

  • A sinus or respiratory infection
  • A cut, scratch, or foreign object in or near the eye
  • A bite from an insect or animal
  • A skin infection, such as impetigo
  • A stye (eyelid bumps) or swelling of the gland that makes tears

What are the signs and symptoms of periorbital cellulitis?

  • Red, warm, swollen eye and eyelid
    Cellulitis of the Eye
  • Fever
  • Discomfort or drainage from your child's eye

How is periorbital cellulitis diagnosed?

Your child's healthcare provider will examine your child's eye, nose, and face. Your child may need any of the following:

  • A vision test checks your child's vision, eye movement, and eye pressure.
  • A neuro exam , or neuro check, may show your child's brain function. They will check how his or her pupils react to light. Your child's strength, balance, and other brain functions may also be tested.
  • Blood tests may show what bacteria is causing your child's infection.
  • A sample of fluid from the surface of your child's eye may show the cause of the infection.
  • A CT scan or MRI may show a foreign object, swelling, abscess, or rupture (tear). Your child may be given contrast liquid to help the pictures show up better. Tell a healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.

How is periorbital cellulitis treated?

Periorbital cellulitis usually goes away within 2 weeks with treatment. Your child may need any of the following:

  • Antibiotics help treat a bacterial infection.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.

What are the risks of periorbital cellulitis?

Without treatment, the infection can spread to other parts of your child's body. Infections in the eye can cause vision loss. Infections that spread to the brain can be life-threatening.

How can I help prevent periorbital cellulitis?

  • Have your child wear proper safety equipment. Protect his or her 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 antibiotic ointment on skin breaks to help prevent infection. Do not let your child swim with a skin wound.
  • Ask your child's healthcare provider about vaccines. The Hib and pneumococcal vaccines help prevent periorbital cellulitis.

Call 911 for any of the following:

  • Your child has trouble breathing.
  • Your child has a seizure.
  • Your child is more sleepy than usual or is hard to wake.

When should I seek immediate care?

  • Your child says his or her neck feels stiff.
  • Your child has a headache and is vomiting.
  • Your child has blurred or double vision and cannot see well in bright light.
  • Your child's infected eye bulges from his or her head.

When should I contact my child's healthcare provider?

  • Your child has a fever higher than 101.5°F (38.6°C) and chills.
  • You see red streaks on the skin of the infected area.
  • Your child's eye is more red and swollen, or starts to drain pus.
  • You have questions or concerns about your child's condition or care.

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 healthcare providers to decide what care you want for your child. 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.

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