Chapter 59: Preseptal and Orbital Cellulitis

Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. Which is the most common cause of orbital cellulitis in all age groups?

a. Bacteremic spread from remote infections b. Inoculation from local trauma or bug bites c. Local spread from the ethmoid sinus d. Paranasal sinus inoculation

ANS: C a. Decreased visual acuity may occur. b. Increased intraocular pressure will be present. c. Optic nerve compromise is a complication. d. The eye is typically spared without conjunctivitis.

Because the membrane separating the ethmoid sinus from the orbit is literally paper-thin, this is the most common source of orbital infection in all age groups. Bacteremic spread, inoculation from localized trauma, and paranasal sinus spread all may occur, but are less common.

2. A child’s optic assessment data include unilateral eyelid edema, warmth, and erythema but no pain with ocular movement is reported. Which characteristic is most likely true about this child’s infection?

ANS: D

This child has symptoms of preseptal cellulitis in which the eye is typically spared. The other findings are consistent with orbital cellulitis.

Multiple Response

NURSINGTB.COM a. Blood cultures b. Complete blood count c. CT scan of orbits d. Lumbar puncture e. Visual acuity testing

1. A patient is experiencing eyelid swelling with erythema and warmth and reports pain with eye movement. Which diagnostic tests will be performed to confirm a diagnosis of orbital cellulitis? (Select all that apply.)

ANS: B, C

A complete blood count will help distinguish infectious from noninfectious orbital cellulitis. A CT scan or the orbits is necessary to confirm the diagnosis. Blood cultures do not confirm the diagnosis of orbital cellulitis but may be used to evaluate whether septicemia is occurring. Lumbar puncture is indicated if meningitis is suspected. Visual acuity testing may be used to monitor recovery.