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Orbital cellulitis — RACP Paediatrics MCQ

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ModerateIDOrbital cellulitisRACP Paediatrics

A 5-year-old presents with periorbital swelling, proptosis, pain with eye movements, and decreased visual acuity in the right eye. Temperature is 39.5°C. There is a history of recent sinusitis. What is the most likely diagnosis?

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Correct answer: D — Orbital cellulitis

Periorbital swelling with proptosis, painful restricted eye movements, and visual impairment indicates orbital (postseptal) cellulitis. It is most commonly secondary to ethmoid sinusitis. This is an emergency requiring urgent CT orbit with contrast, IV antibiotics, and ENT/ophthalmology consultation. Subperiosteal abscess may require surgical drainage.

Reference: RCH Melbourne – 2023 – Periorbital and Orbital Cellulitis CPG