Scribd Logo
Upload

Welcome to Scribd!

  • 123 views

    ENT UK Revised Orbital Cellulitis Flow Chart 2017

    Uploaded by

    Exo L1485
    This document provides guidelines for managing orbital cellulitis in adults and pediatric patients. It outlines indications for admission such as suspicion of post-septal cellulitis, pyrexia, immunocompromise, previous oral antibiotics, or being under 12 months old. For admitted patients, it recommends IV antibiotics such as tazocin or co-amoxiclav depending on age and allergies. Indications for imaging include CNS involvement, inability to examine the eye, or failure to improve on antibiotics. For patients with an orbital collection seen on CT, surgical management such as drainage of pus may be required, while those without a collection can be managed medically.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content

    You might also like

    ENT UK Revised Orbital Cellulitis Flow Chart 2017

    Uploaded by

    Exo L1485
    123 views2 pages
    This document provides guidelines for managing orbital cellulitis in adults and pediatric patients. It outlines indications for admission such as suspicion of post-septal cellulitis, pyrexia, immunocompromise, previous oral antibiotics, or being under 12 months old. For admitted patients, it recommends IV antibiotics such as tazocin or co-amoxiclav depending on age and allergies. Indications for imaging include CNS involvement, inability to examine the eye, or failure to improve on antibiotics. For patients with an orbital collection seen on CT, surgical management such as drainage of pus may be required, while those without a collection can be managed medically.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document provides guidelines for managing orbital cellulitis in adults and pediatric patients. It outlines indications for admission such as suspicion of post-septal cellulitis, pyrexia, immunocompromise, previous oral antibiotics, or being under 12 months old. For admitted patients, it recommends IV antibiotics such as tazocin or co-amoxiclav depending on age and allergies. Indications for imaging include CNS involvement, inability to examine the eye, or failure to improve on antibiotics. For patients with an orbital collection seen on CT, surgical management such as drainage of pus may be required, while those without a collection can be managed medically.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    123 views2 pages

    ENT UK Revised Orbital Cellulitis Flow Chart 2017

    Uploaded by

    Exo L1485
    This document provides guidelines for managing orbital cellulitis in adults and pediatric patients. It outlines indications for admission such as suspicion of post-septal cellulitis, pyrexia, immunocompromise, previous oral antibiotics, or being under 12 months old. For admitted patients, it recommends IV antibiotics such as tazocin or co-amoxiclav depending on age and allergies. Indications for imaging include CNS involvement, inability to examine the eye, or failure to improve on antibiotics. For patients with an orbital collection seen on CT, surgical management such as drainage of pus may be required, while those without a collection can be managed medically.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    ORBITAL CELLULITIS

    MANAGEMENT GUIDELINE –
    FOR ADULTS & PAEDS

    Authors: Stephen Ball, Arthur Okonkwo, Steven Powell, Sean Carrie


    Orbital cellulitis management guideline – For Adults & Paeds

    Is it limited to Preseptal Cellulitis?


     i.e. Eyelid only & eye not involved
     Oral Co-amoxiclav
    (clindamycin if penicillin allergic)
     Consider treating as an outpatient with
    review in eye casualty in 24-48 hours

    No
    Indication for admission – any of:
     Clinical suspicion of post-septal cellulitis
    Baseline Investigations
     Pyrexia
     FBC, CRP, lactate (& blood culture if
     Immunocompromised
    pyrexia)
     Had 36-48 hours of oral antibiotics
     Endonasal swab
     <12 months old
     unable to assess eye due to swelling

    Yes

    Medical management
    Discharge
     ADULTS – iv Tazocin (allergy; Iv clindamycin & iv ciprofloxacin)
     Discharge once swelling
     PAEDS – iv co-amoxiclav (allergy; iv cefuroxime &
    has resolved and
    metronidazole if mild allergy - other allergy discuss with micro)
    pyrexia settled with
     IMMUNOCOMPROMISED- discuss all with microbiology/ID
    oral antibiotics;
     Consider nasal Otrivine & nasal steroids
    -co-amoxiclav
     4 hourly eye & neuro-observations -clindamycin if
     Urgent Ophthalmology assessment & daily review penicillin allergic
     Urgent Otolaryngology assessment & daily review

    Yes

    Indication for imaging


     CNS involvement NO - Discuss
     Unable to examine eye/open eyelids with
     Eye signs – any of: proptosis, restriction/pain microbiology/ID
    on eye movement, chemosis, RAPD, reduced
    visual acuity/colour vision/visual field, optic
    nerve swelling
     Failure to improve or continued pyrexia after No
    36-48 hours IV antibiotics
    Improvement in 36-48 hours

    Contrast enhanced CT Orbit, Sinuses and Brain Continue medical


    management,
    rescan if failure to
    Orbital Collection No Orbital Collection improve after 36-48 Outpatient Treatment
    hours
    Admission

    Surgical management Medical Management


     Approach depends on local skill set
    o Evacuation of orbital pus Imaging
    o Drainage of paranasal sinus pus

    Discuss any intracranial complication with both neurosurgery & Microbiology Surgical Management

    You might also like