Orbital Cellulitis Emergency
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- เผยแพร่เมื่อ 15 ก.ย. 2024
- In this video a teenager presented with an infection of the orbit of the eye. The patient and his parents share their story of how the condition started and its presentation. We also review the treatment and management of this condition.
I am glad the parents are on top of this!
It’s comforting to know that there’s actually a doctor out there that can accurately diagnose cellulitis! I’ve had multiple family members have cellulitis multiple times that the doctors where they were couldn’t figure it out! My mom is a doctor and she could tell just by having their symptoms described over the phone that they had cellulitis but the doctors at the hospital were clueless. I even had one er doc tell me once that my grandmother’s leg wasn’t red because of cellulitis- it was red because it had blood vessels in it. I’m sitting there thinking “ oh really? Well she has blood vessels in both legs so how come they aren’t both red?”
Thank you, Dr. Mellick, for sharing this video, it was very informative. I appreciate you including the CT scans and pointing out what you were looking at.
You are welcome, Chad!
I also enjoy the scans.
One of the best medical educating channels on youtube .. Really recommend it
I wish we have more ophthalmology videos & cases if thats possible
Thanks. We will try whenever possible.
Thank you so much doctor :)
My daughter had this and had to be hospitalized . The doctors told me she had an abscess behind her eye and that it was MRSA. USA Children and women is a good hospital and I'm glad they saved my daughter sight.
Dude this happened to me, I was in SO much pain for so long, went to 3 hospitals, 2 urgent cares and it was terrifying. After 3 days hospitalized with zero change they released me and tbh I was probably not the most pleasant patient to be dealing with after that information. I wasn’t sick or anything prior (to my knowledge) but it’s scary that it’s almost like 4 months later and I still don’t know what happened and I still get long mucus strains. I had an operation to remove the membranes that had started growing ontop of my eye. I can tell u right now it’s SUCH a terrible experience. Moving my eye left or right would sting so so badly. Trying to sleep was just a constant throbbing pain. My first ER trip I was misdiagnosed with an abrasion which probably slowed the real diagnosis process but oh my. Wish I saw this video then!
Thanks for the great presentation. CT scans with report are awesome. Did I miss antibiotic regimen ? In 40+ years of general med and ER work , I've seen this once before. What a neat kid. Hope he did ok. Warm regards, Mike
The abx regimen is discussed from 5:43 onwards
Your videos are absolutely brilliant.... You are impacting so many medical students educations and patients. Hats off sir.
Thank you for your kind comments! Much appreciated.
Great teaching for med student. Much appreciated.
I had a staff infection in my eye about 4 years ago. Totally unrelated I had a cavity formed between my nose and my sinus and both my nose and my eye were infected. First began with swelling and irritation, then a few days later with boils on my face (corner of eyes and nose) had puss coming out. Within a week my nose had a bubble almost the size of a gum ball on the side next to my eye. Well of course me being the person I am. I had scheduled an exam with a free clinic, which ended up being weeks after and by then I had to quit my job, have my girlfriend drive me around and not walk outside without sunglasses(even in the rain) brightness would literally blind me and bring me to my knees for months. Even oncoming headlights in the other side of the road would incapacitate me. Well finally I popped the growth on my nose which forced some of the puss out of the corner of my eye socket( which made everything so much worse). I can honestly say that my right eye has basically lost all focus and ever since has somewhat if a hazy tint now. There hasn't been a single day where i wake up with a clear view in both eyes. However I didn't get sick out of nowhere. I was working and got sprayed in the face with cnc coolant( which had aluminum shavings inside) I had spent most of a few days just pulling out small aluminum shavings out with my fingers, napkins, q tips and multiple dozen eye rinses.
Almost lost my 130lb male German Shepard to cellulitis in his leg. Have no idea how he got it. He had no injuries or were there any trips. If not for taking back to the vet after his first visit to get properly diagnosed by a different vet and on proper antibiotics, he would not have survived. My husband and I had to carry him to the car and cart him into the vet, both visists.
Awesome video. Thanks a lot Dr. Mellick.
I had Erysipelas under my eye that spread down both sides of my face several years ago. Spent 3 days in the hospital getting pumped with Clindamycin...I didn't look like the same person. After three rounds of oral antibiotics post hospital - the infection was STILL coming back. I remember going into work for at least a couple weeks with bentonite clay on my face mixed with tumeric to keep it from spreading to the other side of my face again. It was so embarrassing and one of the worst times of my life.
Finally, I was so desperate and depressed that I took bleach to my face and literally burned the infection away and it worked too!! 😂😅 When I first got into the hospital, I told the doc that I thought I had orbital cellulitis - because I had done my research...but as of yet not enough. He told me, "If it was Orbital cellulitis you would be DEAD by now!!!"
Yikes, so that's my story and I wish the best to everyone suffering. I hope I never go through that again.
Thanks for this really useful educational video for medics to help differentiate vision- threatening orbital cellulitis from similar conditions .If possible, please remove the background music as it's quite irritating & unnecessary.
That's what mute is for
@@marybethsteele7126 How can we hear the commentary if it's on mute genius?
@@Skyismify closed captioning
Another fine video. Do you remember if the patient had anisocoria or if there was just a sluggish response to stimulation? Also, hearing the father's recounting of the symptoms reminds me of how many times more information was gathered from a patient/family the more times they were asked to repeat the symptoms leading up to the presentation. I was burned many times, when I first started, by patients elaborating new symptoms after I presented. The good old days. Hey, stay safe down there! Don't let down your guard for an instant. Cheers!
Thanks for sharing and teaching. May I suggest leaving the music off it’s hard to read what your teaching us with the music. Maybe a softer tone.
I hope the guy is much better now!
Thanks for the suggestion about the music. I use music when there is silence, to keep the videos interesting. I do know that music is distracting to some when they are trying to concentrate.
Larry Mellick it’s just me, the musics great though! I appreciate your videos, in fact I showed my husband a couple last night on shoulder dislocations. He’s been there and found it interesting to watch. I’m an LVN so I find the videos educational. I’m glad I found your site.
My son had this, Dr misdiagnosed a sinus infection. The sinus communicated the infection into to eye socket. Postseptal cellulitis. 5 days in hospital, I had to give 3 times daily antibiotics via a port that was inserted into his upper arm. Did the trick!
Recommend not sleeping on the couch with no blanket covering the couch because right now I think have it
I have a bad pimple on the left side of my nose near my eye, I went to ER and they diagnosed me with this.
He also has an infected left maxillary sinus below the eye.
As was noted in the exemplary radiology comment
Knock on wood, I've never had it anywhere but on my legs. I have gotten it pretty bad on my legs and even been in your hospital, a few times. Bless his heart, I know that's got to hurt.
Rear upper molar dental abscess can expand an involve the eye.
Great teaching video
Thank you for this! I am almost 50 and went to my primary yesterday. Was told I just have allergies and to go pick up two over the counter products that cost me $70 bucks and did absolutely nothing. Going to E.R. today where it will actually get properly diagnosed. Looks just like his eye here and I have the same symptoms. I have worn contacts since I was 11 years old. I know eye allergies lol
Wow, great work
Good video with easy to understand diagnosis.
I’m going through that right now at the hospital…. It’s pretty damn serious and a bit scary too
Just got out of surgery for it also, hope it went well brother
@@torn8to277 can u describe the procedures of the surgery. If you mind?
How long till you fully recovered?
I was in hospital for 3 weeks over this
Is this presentation a complication of sinusitis (seen on CT) which may be due to nasal spur?
The sinusitis is the culprit. I am not sure about the role of any nasal spur.
@@lmellick Ok, thanks😃
Your videos are really great, they are unique in the way that they are patient based rather than being completely theoretical.
thank you Dr.
You are welcome!
A buddy of mine in basic training developed this. When he went to sick call, they thought it was pink eye, so he got a shot of penicillin which it turned out he was allergic to. He was flown out to a local university hospital for care.
Oof sounds like a big payday hope he sued!
@@barrybilly5822 "Spouses and dependents of military personnel may be able to sue a military doctor for injuries caused by medical negligence, but active duty members are typically barred from making a claim for injuries that may have resulted from sub-standard medical treatment at a DOD or VA hospital, or any other military health care..."
www.alllaw.com/articles/nolo/medical-malpractice/claims-against-military-doctors-hospitals.html#:~:text=Spouses%20and%20dependents%20of%20military,any%20other%20military%20health%20care
@@barrybilly5822 he can’t sue if he didn’t know, or if he did know but didn’t tell them, he was allergic to Penicillin! You don’t know you’re allergic to something until the first time you have a reaction to it.
Hey doc I had this more than 5 times in three months after it got cured naturally after some weeks my vision was affected especially my night vision I saw halos ,starbrust around lights and I even experience ghosting , double image and also I saw a lot of flowers on my vision what should I do please help me with your advice
@M M are you doc man
Thanks dr
Castile foaming hand soap with eucalyptus and tea tree has worked the best for the cellulitis and folliculitis on my forearm so far.
It killed the bad bacteria and allowed my skin to heal and naturally exfoliate as well.
I used it 3 times a day and especially in the shower with very warm water so the natural ingredients could go deeper into the skin layers. Just gentle massaging as you wash the area works.
Just make sure to moisturize with coconut oil or a carrier oil afterwards to keep the skin hydrated.
I got this at Sprouts and you can get it any health foods store or Whole Foods. Go buy this now!
Have you tried chlorhexidine (hibiclens) soap? What about betadine pre-op scrub soap?
@@mannys9130 I haven’t, the Castile soap with tea tree has been the most easily available, affordable, and effective solution by far with an exfoliation towel and two a day showers. My cellulitis and anxiety is completely gone now with the protocol I used.
I don’t even know what causes this type of infection, but luckily I’ve never had it - eyes are the most sensitive, and I hope I never get anything that affects my eyes, yikes!
Castile soap in the eyes is a bad idea. I got some in my eyes once. The pain was excruciating. Avoid this around the eye completely.
@@Sachistar7591 try around the eye first and massage in, if a little gets in the eye it may be painful but know that it’s better than the eye infection getting worse. Healing doesn’t always feel good at first when the bad bacteria is dying off.
Please let us know about the follow up as well. Is he suffering from some chronic respiratory tract pathology like cystic fibrosis or bronchiectasis? I've never seen sinusitis get this bad!!!
I had orbital cellulitis 3 times in 3months it came back worse in worse third time I was sent to the emergency room an put me on 3or4 types of Iv’s for 18-20hrs a day for a week and later had to up the dose Bc there was little results at first an I had a risk of kidney failure but I recovered from it after a week
That is so scary. I’m glad you’re okay now and it stays that way!
I remember getting stung by a wall on the eyelid and it looked like I had periorbital cellulitis but that was the wasp venom causing my eye structures to swell, I wasn't able to open my eye for over 24 hours and well It got better in 2 weeks but I have slightly decreased vision in my left eye because of it
It doesn't matter anyway my eyes are doodoo garbage
But my glasses help
That must have been one bass ass wall!
The video “patella dislocation emergency” isn’t working :( any plans to re-post? Great video dr. Mellick! Thanks!
Oliver Yes I just noticed that the title had disappeared. I will re-post it in about an hour.
Why the diagnosis suggest myositis of the right SRM of an eye? Any MRI indications of that?
I don't think they did an MRI. We only did a CT in the ED.
I have orbital cellulitis and Mercy in Springfield refused to drain it and sent me home with antibiotics if I die because of it its time to sue i wiah we had good doctors over here in Massachusetts
Ouch looks painful
mrsNetty34 it is tbh
Yes it is.
It was helpful thank you..
You're welcome!
Please how the hell can i cure this plssss
Wow sorry one question regarding indications for ct + contrast for Paeds < 1 year of age. As a radiographer that’s a really hard scan to get a diagnostic appropriate image. Are you recommending sedation?
Thank You for the case. The music was fine.
You are welcome, I ,too, kind of like the music. Everyone has different opinions about whether or not to add music or the choice of music made. Without music the videos are just a tad less interesting, in my opinion.
Larry Mellick don’t use the music In all cases
@@lmellick I hate the music. But love your informative videos. :)
I've had this before and it is very painful and on top of that I had a cold
Did you lose your vision? I currently have it. Thanks for the answer
Did you lose your vision? I currently have it. Thanks for the answer
Would you consider this a bounceback case?
Probably not since the swelling was gone when he came to the ED.
this is very serious esp if its on you face.
I almost died of this
Damn, happy you made it
@@farcenter thank u
Hey did you vision come back? I’m scared I’m losing my vision right now
@@sandersabm no
Wow I literally just healed the first week of this month (April) & my vision didn’t come back in my right eye 😢 I went from a 20/20 to a 20/50. My right eye looks like I’m staring through a clear shower curtain!!
Is this infectious ?
No, it isn't.
Sir,y not used clindamycin in place of metronidazole for anerobes( intracranial extension), though got lots of information from u & background music is superb.tnks for sharing knowledge.
Clindamycin does not do a good job of crossing the blood brain barrier and is not recommended for that reason, I assume.
I have had orbital cellulitis before. I had to get surgery on my eye
Hello, I have cellulitis underneath my eyelid. I don't have insurance, after I went to the ER I have eye drops. I wonder how long the healing will take if I had it from Sept. 9, 2020. Does anyone know know how long the healing process takes?? Thanks! Greetings from South Florida🌞🌴🌻
I just Googled it: Uncomplicated orbital cellulitis can be treated with antibiotics alone. Treatment regimens are usually empiric and designed to address the most common pathogens as described above because reliable culture results are difficult to obtain in the absence of surgical intervention. For patients with uncomplicated orbital cellulitis, it is suggested that antibiotics be continued until all signs of orbital cellulitis have resolved. The duration of antibiotic therapy ranges from a total of at least 2 to 3 weeks.
Please keep on top of this Buttercup and go back to the ER if things are resolving. It sounds pretty nasty.
@@thebluehotel426 I have antibiotics eye drops that are OK however it's not getting rid of my tiny lumps which I have 3 tiny lumps underneath my eyelid and my upper eyelid is so sore. Its scratchy and sometimes very crusty in the mornings and its frustrating since I have to work for a Luxury Dept. Thanks, I'm just worried if I go back to the ER to follow up it'll be more expensive then what I can afford...thank you again!
I had orbital cellulitis 3 times in 3months it came back worse in worse third time I was sent to the emergency room an put me on 3or4 types of Iv’s for 18-20hrs a day for a week and later had to up the dose Bc there was little results at first an I had a risk of kidney failure but I recovered from it after a week
I have swollen eye like this every week and i dont know what the best treatment
May be you have been allergic to something or exposed to some virus !
Interesting video however what really awful music!
I had this when I was 9.....not fun at all.
What is the treatment???? C’mon
Antibiotics IV and chirurgical drainage of the absess PRN
It says on the cards at the end of the video
What’s with the music????
why like why have stupid music playing when you're watching a kids x-rays with a fccd up eye??
Right? Sounds like a 70’s (bad) soap opera!
Looks nasty 🤮
I almost died from it
@@thatboichase3408 🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻
Don’t fart in pillows
lol nothing to do with "farting in pillows" thats "Pink Eye" / Conjunctivitis
Bruh don’t sleep on a couch we no sheet because bruh I got this
dancing or study ??? music not good here
Thank you sir!
But not too explicit next time improve on it 🙏
1빠
Get you feet of the chair woman!
Why is he in the hospital what wrong what his eyes why he have his eye close the left side are the right eye is close What is ct stand for how long will he be in the hospital need to what for the nuser to draw blood in his arm to put a iv
Watch the video again! Pay attention to the end of the video with the flash cards. Don’t be afraid to pause the video and read each card for comprehension before moving on!
Kid is in the hospital for evaluation and treatment of a abscess that could cause permanent vision damage if not treated properly. He will need pain meds, and strong antibiotics to treat the infection as well as monitoring to make sure it doesn’t travel to his brain which can be deadly.