| Ophthalmology |
- Consult Ophthalmology for children requiring admission for orbital or preseptal cellulitis
- Ophthalmology to evaluate child in ED if:
- Surgery may be indicated, including children with:
- Large orbital abscess
- Evidence of optic nerve compromise (decrease in vision, rAPD, optic nerve head changes)
- Diagnosis, decision to image, or decision to admit is unclear
- Unable to assess the eye surface in order to identify orbital signs
- Timely Ophthalmology consultation in the ED or inpatient unit is recommended for children with orbital cellulitis if surgery is not currently indicated
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| Otorhinolaryngology (ENT) |
- Concurrent sinusitis is present
- Consult from the ED if surgery is being considered
- Consult from inpatient if surgery is not being immediately considered
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| Neurosurgery |
Concern for intracranial involvement |
| Infectious Disease |
- Lack of response to first-line recommended IV or PO treatment regimen
- Drug allergy prevents use of recommended agents
- Immunocompromised child
- Recent trauma
- Intracranial involvement
- Interpretation of operative culture results
- Oral conversion if vancomycin was used
- Concern for sight-threatening infection
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