Clinical Pathway for Patient with Suspected Preseptal or Orbital Cellulitis
Concern for Sepsis
ED Sepsis Pathway
No Orbital Signs
Unclear Orbital Signs
Clear Orbital Signs
Preseptal Cellulitis
Orbital Cellulitis
Discharge
Admit
Admit Inpatient
Admit OR Surgical Drainage
  • Admit PICU
  • Altered mental status
  • Sepsis
  • Intracranial extension
  • Consult as indicated
    • ID, Neurosurgery
Inpatient Care
Inpatient Care
Monitor Response to Therapy
Monitor Response to Therapy
More frequent exams as clinically indicated
Daily Ophthalmology Service Exam
More frequent exams as clinically indicated
  • Improved
    • Clinical findings
    • Fever curve
  • Tolerating PO intake
  • After 36 hours of treatment
    • No improvement
      • Clinical findings
      • Fever curve
  • Improved clinical findings
  • Afebrile for 24 hours
  • Tolerating PO Intake
  • After 36 hours of treatment
    • Worsening orbital signs by ophtho exam
Discharge
Discharge
Posted: April 2019
Revised: June 2019
Authors: Binenbaum, G. MD; Lin, L. BS; Kuhn, I. CRNP; Russo, M. MD; Kaur, T. MD; Lavelle, J. MD; Hayes, M. PharmD; Katowitz, W. MD; Reddy, K. MD; Rizzi, M. MD; Revere, K. MD; Buzi, A. MD; Blackstone, M. MD; Wilbur, C. MD; Scheid, V. MD