Periorbital Cellulitis (being ambulated on IV antibiotics)

Advice intended for parents/carers taking their child home after seeing a hospital based healthcare professional

Periorbital cellulitis is an infection of the eyelid or skin around the eye. It is almost always one sided and sometimes follows a cut or graze to the skin.

Symptoms

  • Swollen eyelid
  • Eye area can be red, tender and warm to touch
  • Fever may be present
  • Your child may be unable to open the eye fully

Causes

  • Periorbital cellulitis can follow a minor injury to the eye
  • It can also occur following another infection, such as a cough or cold, where the infection spreads to the eye or following sinusitis.

Treatment

Periorbital cellulitis usually responds well to antibiotics. Treatment with intravenous antibiotics (given into a vein) is usually only needed for more severe cases or those that have not responded to antibiotics given by mouth.

Some children who need intravenous antibiotics are admitted to hospital initially whilst others can be looked after at home. These children would come into hospital once a day for someone to look at them and for their antibiotics to be given.

The decision on when to change from intravenous to oral antibiotics (tablets or liquid) will be made by the medical team caring for your child. This will depend on how quickly your child responds to treatment (improvement in fever, pain and sometimes their blood tests) and whether your child has other health conditions. Antibiotics are usually given for a total of 10 days. You can give regular pain relief (Paracetamol or Ibuprofen) until any discomfort has improved.

Complications

Most children recover without any complications. However, periorbital cellulitis can occasionally progress to orbital cellulitis. This is where the infection involves the deeper tissues around the eye and the eyeball itself.

This is a serious infection, which can cause lasting problems and needs immediate care.

If you are concerned that your child's condition is getting worse, you should contact your discharging ward.

Thing to look out for include:

  • The swelling becoming worse, not better
  • Pain when moving the eye
  • If the eye appears to stick out or bulge
  • Worsening of fever
  • Fast heart beat
  • Fast, irregular or difficult breathing
  • Changes in behaviour, such as confusion or disorientation

Call 999 for an ambulance if you have serious concerns for your child.

Prevention

It is not always possible to prevent this infection. However, it is important to have your child fully vaccinated, as two of the bacteria known to cause this infection are covered within your child's current vaccination schedule.

Keep any minor injuries surrounding the eye clean and dry. Remember good hand hygiene before and after cleaning around the eye.

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