What is Pre-Septal Cellulitis?

Pre-septal cellulitis, also known as periorbital cellulitis, is a common yet potentially serious infection that affects the eyelid and surrounding tissues. This condition primarily occurs in children but can affect individuals of any age.

Photo by Karolina Kaboompics

Introduction

Pre-septal cellulitis is an infection of the soft tissues around the eye, specifically the eyelid and the area just outside the eye socket. It is characterized by inflammation and swelling, and it can be differentiated from orbital cellulitis, a more severe infection that involves the deeper tissues of the eye socket.

The condition gets its name from the “septum,” which is a thin membrane that separates the eyelid’s tissues from the deeper orbital structures. When the infection is confined to the area anterior to this septum, it’s classified as pre-septal cellulitis.

Symptoms of Pre-Septal Cellulitis

The symptoms of pre-septal cellulitis can vary in severity but commonly include:

• Swelling and Redness: The most noticeable sign is swelling of the eyelid and surrounding areas. This swelling is often accompanied by redness.
• Pain and Tenderness: The affected area may be painful or tender to the touch.
• Fever: Patients, especially children, may develop a fever as the body responds to the infection.
• Warmth: The infected area may feel warm due to increased blood flow and inflammation.
• Conjunctivitis: In some cases, symptoms may include conjunctivitis, or “pink eye,” which can cause discharge and irritation of the eye.

Causes of Pre-Septal Cellulitis

Pre-septal cellulitis often results from a bacterial infection. Common causes include:

• Sinusitis: Infections or inflammation of the sinuses can spread to the eyelids.
• Trauma: Any injury to the eyelid or surrounding area, including insect bites or scratches, can introduce bacteria.
• Hordeolum (Stye): An infection of the eyelid’s oil glands, which can appear as a lid lump, can sometimes lead to pre-septal cellulitis if not treated promptly.
• Upper Respiratory Infections: Infections like the common cold can sometimes contribute to the development of pre-septal cellulitis.

Diagnosis and Evaluation

Diagnosing pre-septal cellulitis typically involves a physical examination, where a healthcare provider will assess symptoms and check for signs of infection. While not always needed, imaging such as a CT scan may be used to rule out orbital cellulitis or other complications.

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Treatment Options

Prompt treatment of pre-septal cellulitis is crucial to prevent complications. Treatment typically involves:

• Antibiotics: Oral antibiotics are usually prescribed to target the specific bacteria causing the infection. The choice of antibiotic depends on the suspected pathogen and the severity of the infection.
• Warm Compresses: Applying warm compresses to the affected area can help reduce swelling and provide relief from discomfort.
• Pain Management: Over-the-counter pain relievers may be recommended to alleviate pain and fever.

In severe cases or if the condition does not improve with oral antibiotics, intravenous antibiotics or hospitalization may be required.

Photo by Ksenia Chernaya

Prognosis and Outlook

The outlook for pre-septal cellulitis is generally positive with appropriate treatment. Most individuals recover fully without any long-term complications. However, it is essential to follow medical advice and complete the entire course of antibiotics to ensure the infection is fully eradicated.