Investigation and management of adult periorbital and orbital cellulitis.

BACKGROUND: Orbital cellulitis has important complications. Despite this, there are few studies in the literature of large groups of cases of this condition. METHODS: We performed a retrospective case analysis of all patients admitted with periorbital and orbital cellulitis between 2002 and 2004. RESULTS: A total of 27 cases were included in the study. Of these, 25 had undergone a computed tomography scan, 19 of which had revealed significant sinus disease; 10 had had a microbiology result, with the most common organism being Streptococcus milleri; 20 had had a white cell count taken, with raised results in only 10; 12 had undergone surgery; and 25 had made a good recovery. One case had been found to be squamous cell carcinoma of the nasal cavity. CONCLUSIONS: In this study, sinus disease was the commonest cause of orbital cellulitis, with the commonest organism being Streptococcus milleri. Only 50 per cent of cases with proven disease had had a raised white cell count; this is therefore not a very sensitive test.