
This child who had a recent ED visit for acute sinusitis presents with swelling and erythema around her eye. Eye movements are painful. You note chemosis, proptosis, and mild globe displacement on exam. It is difficult to test visual acuity since she complains about seeing double. She refuses extraocular movement testing.
Challenge: What's the diagnosis and what are the bugs?
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Orbital Cellulitis
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Satellite
Orbital cellulitis is caused by Staph aureus and Streptococcci (less commonly H. influenzae, Eikenella, and anaerobes). Orbital cellulitis is sight and life threatening.
Sources: UpToDate; lib.uiowa.edu.