Periorbital Cellulitis Differential Diagnosis
- Single most likely diagnosis
- Bacterial periorbital cellulitis: This is the most common cause of periorbital swelling and erythema, often resulting from direct spread of infection from the paranasal sinuses, skin, or eyelids. Staphylococcus aureus and Streptococcus pyogenes are common pathogens.
- Other Likely diagnoses
- Allergic reactions (e.g., to insect bites or contact dermatitis): These can cause periorbital swelling and erythema, but typically lack the warmth, tenderness, and purulent discharge seen in bacterial infections.
- Insect bites: Similar to allergic reactions, insect bites can cause localized swelling and erythema around the eyes.
- Trauma: Blunt trauma to the orbit can cause periorbital swelling and ecchymosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Orbital cellulitis: This is a more severe infection involving the orbital tissues posterior to the orbital septum, which can lead to serious complications such as vision loss, cavernous sinus thrombosis, and intracranial infection.
- Necrotizing fasciitis: A rare but life-threatening infection that can cause rapid progression of periorbital swelling and necrosis.
- Meningitis or intracranial infection: Although rare, these conditions can present with periorbital swelling and erythema, particularly if there is associated sinusitis or orbital cellulitis.
- Rare diagnoses
- Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis): A systemic vasculitis that can cause periorbital swelling and inflammation.
- Sarcoidosis: A systemic disease that can cause periorbital swelling and uveitis.
- Erythema multiforme: A skin condition that can cause periorbital swelling and targetoid lesions.