What is the management for orbital cellulitis?

• A. Hospitalization, IV antibiotics, possible surgery, urgent consults.
• B. Oral antibiotics at home.
• C. Topical steroid drops only.
• D. No treatment needed.

Answer: (A)

Orbital cellulitis is an emergency infection behind the orbital septum that can threaten vision and spread to the brain, so it requires inpatient, aggressive treatment. The best management is hospitalization for intravenous antibiotics that cover likely organisms from the sinus-associated flora (including Staphylococcus aureus, Streptococcus species, and anaerobes), with rapid imaging to assess extent and look for abscess. Urgent ophthalmology and ENT consultations are essential to guide imaging, possible drainage, and sinus management. If an orbital abscess or failure to improve on IV therapy occurs, surgical drainage may be needed. Oral antibiotics at home, topical steroids alone, or no treatment do not provide adequate control and pose serious risk to vision and life.