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Periorbital cellulitis

  • Sx

    • unilateral periorbital pain, edema, erythema, warmth.
    • lack of concerning symptoms such as vision changes, pupil abnormality, EOM defect
  • Labs

    • CT if suspect orbital cellulitis (vision changes, pupil abnormality, EOM defect)
  • Tx

    • Clindamycin 300 mg q8h (30-40 mg/kg per day in 3-4 equally divided doses, max 1.8 g/day)
    • f/u in 24h with optho
    • if age < 5 or significant comorbidities:
      • ophtho consult for admission
      • cefuroxime 50 mg/kg IV q 8 hours + vancomycin if MRSA
  • ROS

    • pain: quality, quantity, aggravation, alleviation
    • edema, erythema, warmth, drainage
    • fever
    • vision
    • headache
  • Px

    • vitals: fever, HR
    • vision (gross)
    • pupils
    • EOM
    • lid, periorbital: edema, erythema, rash, vesicles, warmth, tenderness
    • eye: conjunctivitis, drainage, vesicles
    • sinus tenderness
    • lymphadenopathy

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