Emine Kalkan Akçay, Gamze Dereli Can, Nurullah Cagil

Preseptal and Orbital Cellulitis

Preseptal selülit (PS) göz kapağı ve çevresindeki dokunun iltihabi reaksiyonu iken orbital selülit (OS) orbitayı ve onun içeriğini etkileyen septum arkası dokuların iltihabıdır. Göz çevresi yapılar; travma (sıklıkla böcek ısırığı) veya primer bakteremiye bağlı olarak enfekte olur. Orbital selülit çoğunlukla sinüzite sekonder iltihabi olayın orbita içine ilerlemesiyle oluşur. Sıklıkla kültürlerden üretilen patojenler Staphylococcus aureus, Streptococcus pneumoniae, S. epidermidis, Haempphilus influenzae, Moraxella catarrhalis ve S. pyogenes’dir. Tanıda OS ve PS’yi ayırt etmek için önerilen yöntem bilgisayarlı tomografik görüntülemedir. Uygun antibiyoterapi OS ve PS’de tedavinin ana basamağıdır. Cerrahi drenaj total oftalmopleji, görsel kayıp veya büyük belirgin abse gelişiminde endikedir.Bu enfeksiyonlar çocuklarda akut görme kaybı, kavernöz sinus trombozu, menenjit, serebrit, endoftalmi, beyin absesi gibi komplikasyonlara neden olabilir. Bu nedenle bu enfeksiyonların erken tanınması ve doğru tedavi edilmesi oluşabilecek ciddi enfeksiyonların önlenmesi açısından çok önemlidir. Bu yazıda PS ve OS’nin tanı, tedavi, yönetim ve komplikasyonları özetlendi

Anahtar Kelimeler:

Enfeksiyon, orbita, preseptal, selülit, tanı, tedavi

Preseptal and Orbital Cellulitis

Preseptal cellulitis (PC) is defined as an inflammation of the eyelid and surrounding skin, whereas orbital cellulitis (OC) is an inflammation of the posterior septum of the eyelid affecting the orbit and its contents. Periorbital tissues may become infected as a result of trauma (including insect bites) or primary bacteremia. Orbital cellulitis generally occurs as a complication of sinusitis. The most commonly isolated organisms are Staphylococcus aureus, Streptococcus pneumoniae, S. epidermidis, Haempphilus influenzae, Moraxella catarrhalis and S. pyogenes. The method for the diagnosis of OS and PS is computed tomography. Using effective antibiotics is a mainstay for the treatment of PC and OC. There is an agreement that surgical drainage should be performed in cases of complete ophthalmoplegia or significant visual impairment or large abscesses formation. This infections are also at a greater risk of acute visual loss, cavernous sinus thrombosis, meningitis, cerebritis, endophthalmitis, and brain abscess in children. Early diagnosis and appropriate treatment are crucial to control the infection. Diagnosis, treatment, management and complications of PC and OC are summarized in this manuscript.

Keywords:

infection, cellulitis, orbita, preseptal, diagnosis, treatment,

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