acute orbital cellulitis
Introduction
Introduction to acute orbital cellulitis Acute suppurative inflammation in the soft tissue or subperiosteal of the iliac crest often has a tendency to spread into the brain, causing permanent vision loss or cavernous sinus thrombosis or purulent meningitis and life-threatening. Any perforation wounds around the eyelids and the separation of the eyelids, contaminated foreign bodies, pathogenic bacteria on the skin surface around the eyes or in the conjunctival sac, or normal bacterial flora can cause acute infectious inflammation as the wound enters the orbital soft tissue. Inflammation often occurs 48 to 72 hours after trauma. If a foreign body enters, sometimes infectious inflammation occurs several months after the trauma. Symptomatic treatment for the cause, systemic application of a large number of broad-spectrum antibiotics, combined with the application of corticosteroids, when the tumor appears on the conjunctiva or skin surface, cut the pus, and put the rubber strip drainage, inflammation of the adjacent tissue, should be corresponding deal with. basic knowledge The proportion of sickness: 0.01% - 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: exposed keratitis corneal ulcers oppressive optic neuropathy optic neuritis retinal detachment meningitis abscess thrombophlebitis
Cause
Causes of acute eyelid cellulitis
Cause:
Eyelid trauma or post-operative infection, total ocular inflammation, cavernous sinus thrombosis, sinusitis, facial edema or erysipelas, and spread of infections in adjacent tissues such as oral lesions can lead to the occurrence of sputum cellulitis, which is multi-hemolytic streptococcus Staphylococcus aureus.
Systemic infectious diseases, such as sepsis, scarlet fever, bacteria invade the orbital tissue through the bloodstream to cause infection.
Prevention
Acute eyelid cellulitis prevention
The indications for antibiotics should be strictly controlled to avoid unreasonable abuse of antibiotics.
Complication
Acute orbital cellulitis complications Complications exposed keratitis corneal ulcer oppressive optic neuropathy optic neuritis retinal detachment meningitis abscess thrombophlebitis
(A) corneal involvement: due to eyeball protrusion, corneal exposure, prone to exposed keratitis, and can develop corneal ulcers, perforation, blindness.
(2) Those with serious gangrene in their eyes have gangrene in their eyes and have fallen carrion.
(C) optic neuropathy: due to increased pressure, optic nerve compression, central retinal vein and its supporting blood vessels are squeezed, so the optic nerve head can edema, if the inflammation infiltrates into the optic nerve sheath and optic nerve essence, can occur at the same time optic neuritis There may be focal abscesses and necrosis in the optic nerve, and the optic nerve will soon shrink, vision loss and even blindness.
(4) Retinopathy: Due to the involvement of central retinal vessels, retinal hemorrhage, retinal vein occlusion or retinal artery occlusion, or exudative retinal detachment.
(5) Sclera, choroiditis and other inflammation can affect the sclera, choroid and retina and other tissues, may have acute focal necrosis.
(6) Cavernous sinus thrombophlebitis: Inflammation extends posterior to the cavernous sinus, forming cavernous sinus thrombophlebitis or causing meningitis or abscess and death.
(7) Systemic infection: Inflammation can occur through blood supply to toxemia or sepsis.
Symptom
Acute eyelid cellulitis symptoms Common symptoms Eyelid edema nipple edema convulsions coma eyelids have obvious... Eyeball acute disease
1, systemic symptoms:
The onset of inflammation is acute, the body temperature rises and the aversion is cold, and it is acutely ill, chills, fever, headache, malignant vomiting, and even coma and convulsions.
2, eye symptoms:
Eyelid edema, eyeballs are prominent, eye movement is limited and fixed, the conjunctiva is highly edematous and protrudes beyond the cleft palate, the pain in the palate is obvious, the pain is increased when the eyeball is rotated or oppressed, and if the inflammation invades the optic nerve, it causes optic papilla edema. , congestion, vision loss or even blindness, if the inflammation is worn out to the conjunctiva or skin, the symptoms are relieved and subsided, and if the inflammation spreads backward into the cranial cavity, it may cause serious intracranial complications, which may be life-threatening.
Examine
Examination of acute eyelid cellulitis
1 history, eye symptoms and signs.
2X light film except for sinusitis.
3 Please consult the otolaryngologist for sinusitis.
4 Take the secretion of conjunctival sac or the secretion of skin ulceration or conjunctival sac rupture as smear, check with Gram stain, and at the same time make bacterial culture; 5 take nasopharyngeal secretion for bacterial culture and smear examination.
Diagnosis
Diagnosis and diagnosis of acute orbital cellulitis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
(a) cavernous sinus thrombophlebitis.
(B) the onset of fasciitis is rapid, both sides are mostly, the inflammation begins to be limited to the tendon of an extraocular muscle, the movement is limited, the eyeball is prominent, the conjunctival edema, if it is suppurative, the conjunctiva at the lower edge of the inferior rectus muscle There is a yellow pus area underneath.
(3) The symptoms of sacral osteomyelitis are similar to those of other acute sputum-stricken syndromes. The pupils are scattered, the light and aggregation reflexes disappear, the eyeballs are restricted, the ptosis is drooping, and the corneal sensation disappears.
