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orbital cellulitisOphthalmology Acute infection of the tissues of the eye, with potentially serious complications Etiology Bacterial infection, usually an extension from the ethmoid or para-nasal sinuses, regional abscesses, trauma to eye, or foreign object Agents H influenzae, S aureus, S pneumoniae, beta hemolytic streptococci
or·bi·tal cel·lu·li·tis(ōr'bi-tăl sel'yū-lī'tis)
cellulitis(sel?yu-lit'is ) [ cellula + -itis, ]
Bacteria gain access through breaks in the skin and spread rapidly, overwhelming normal body defenses; lesions between the toes from athlete's foot are common entry sites.
For mild cases of cellulitis, oral antibiotics may be effective depending on the causative organism. For severe cases, intravenous penicillinase-resistant penicillins are used; surgical débridement to obtain cultures and to rule out fasciitis is recommended for patients with diabetes.
CAUTION!Rarely, group A streptococcal cellulitis may be complicated by exfoliative dermatitis or infection of the subcutaneous fat and fascia, causing necrosis (necrotizing fasciitis), a condition popularly ascribed to the action of “flesh-eating bacteria.”
Blood cultures should be obtained from patients with cellulitis to assess for sepsis before beginning therapy with antibiotics. The affected body part should be elevated above the level of the heart. Outlining the affected area with a skin marker allows the caregiver to readily determine if inflamed tissues are responding to therapy. Size, shape, color, and temperature of the affected area and surrounding tissues should be documented and any drainage described. Applying warm soaks to the area increases vasodilation, thus decreasing edema and relieving pain. Pain should be treated with prescribed oral analgesics and anti-inflammatory drugs. Blood sugars, if elevated, should be lowered to normal levels (preferably about 126 mg/dl or less). Patients on prolonged bedrest should be given heparin to prevent deep venous thrombosis as well as stool softeners to prevent constipation. Patients who develop cellulitis are often at risk for recurrence; they should learn general skin hygiene, how to clean cuts, scratches, cracked skin, and abrasions, and the importance of prompt treatment for infections.