Preseptal Cellulitis: A Multidisciplinary Perspective on Diagnosis and Treatment

Abstract

Introduction: Preseptal cellulitis is a common pediatric infection involving the eyelid and anterior orbital tissues, characterized by eyelid erythema and edema. Although most cases respond well to oral antibiotics, delayed diagnosis or inadequate treatment may lead to complications requiring more intensive management. Case Presentation: A febrile 7 year-old boy presented with progressive swelling, erythema, and purulent discharge of the right upper eyelid for two weeks despite prior oral antibiotic therapy. Examination revealed marked palpebral edema, tenderness, and a superior eyelid mass without proptosis or limitation of ocular motility. Laboratory findings showed elevated C-reactive protein levels. Orbital CT imaging confirmed preseptal cellulitis without orbital involvement. The patient was hospitalized and treated with intravenous ampicillin-sulbactam. Discussion: Preseptal cellulitis most commonly affects children under 10 years old. While mild cases can be managed with oral antibiotics, severe or unresponsive cases require intravenous therapy. The absence of proptosis and preserved ocular motility were key features distinguishing this condition from orbital cellulitis. Conclusion: Prompt recognition and timely intravenous antibiotic therapy are crucial in severe preseptal cellulitis to ensure clinical improvement and prevent progression to orbital complications.