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Original poster

Periorbital cellulitis - please help!

56 replies

Iflippinghateplaydoh · 31/03/2019 22:51

Ds (3yo) went to bed Friday night with a very slightly swollen eye.
Saturday morning-completely swollen. No pain just wouldn't open.
Out of hours gp gave eyedrops for conjunctivitis whilst telling me "I'm not sure that it is conjunctivitis" Angry
Today (Sunday) ds wakes up crying. His eye is purple, swollen, closed over and he is saying his head is hurting and temp of 40. Call 111. Sent to out of hours who immediately sends us to a&e. All rushed through very fast and within 20 mins we are up on a ward he has numbing cream on his hand ready for iv antibiotics. Doctor goes off and speaks to consultant and between them decide they think it is periorbital cellulitis and not orbital and give oral antibiotics 3x a day for 10 days. We were under strict instructions return straight to the ward if we have any concerns that things are worsening or not improving fast enough just call ahead first.
We left hospital at 1pm and ds has slept since then. He won't eat (hasn't since tea yesterday) and just keeps crying saying his head is hurting. He's had 2 doses of antibiotics and his temperature has been 38.3 at lowest all day despite regular Calpol and Nurofen.
I am worried so I called the ward and she completely shot me down, saying that I've allowed no time for medicine to kick in yet. I'm also worried about the diagnosis being wrong as everything I've read (I know, I know) says that periorbital comes from a cut or a bite etc but ds had absolutely no signs of anything like that. He's had a cough and a snotty nose for a couple of days prior.
Would you go back tomorrow or should I allow longer for the meds to work? The eye DOES look less swollen tonight as in he is able to open a couple of mm, but it's the lethargy, temperature (currently 39) and the lack of appetite that are making me worry.

OP posts:
Original poster
Iflippinghateplaydoh · 31/03/2019 22:54

So you can see how it looks Sad

Periorbital cellulitis - please help!
OP posts:
CharlesChickens · 31/03/2019 22:57

Yes I would go back.
My dd had the beginnings of periorbital cellulitis. The GP initially said it was conjunctivitis, which it very obviously was not. Second GP the next morning said maybe allergy. I had a bad feeling and we took her to A and E, where they mulled over keeping her in on iv antibiotics but decided to send her home with oral ones. Within one dose there was a noticable improvement, but after three you could see the eye was really deflating.
She had no cut or graze there, but had splashed pond water in her eye a day or so before.
As your child is still so unwell I think going back to A and E is totally reasonable. I hope he improves soon.
When my dd was diagnosed the doc was more concerned by her lethargy than the swelling itself. Go back.

Namechangedagain2 · 31/03/2019 22:59

No advice really but my son had this and was in hospital for 5 night with it on iv abtibiotics. His didn't come from a cut or anything like yours he had a cold and I was fobbed off that it was conjunctivitis.

CharlesChickens · 31/03/2019 22:59

Your poor little boy. Get him in the car, he needs to be seen again, if only to absolutely be sure that he doesn’t need admitting on iv antibiotics.

Namechangedagain2 · 31/03/2019 23:00

If you're worried I'd call 111

DangerMouse17 · 31/03/2019 23:00

That picture is heartbreaking OP. I'm so sorry your little one is suffering. Have you got an actual eye hospital near you...Moorfields or something? I would be tempted to take to A&E there to check again. Headache could be an increase in pressure behind the eye and they would be best placed to actually check...?

minipie · 31/03/2019 23:02

The head hurting would worry me, at 3yo he could mean his eye hurts. I’d take him back. Sorry and do hope all is well.

FWIW I’ve twice taken a small DC into A&E and they turned out to be fine, each time I was told “don’t worry we’d always rather check out little ones if in any doubt”.

BookClubBlues · 31/03/2019 23:02

Go back - when my dd has this she began getting better within a couple of hours of starting anitibiotics. I presume they took a swab so may be able to check they have given appropriate antibiotics by now?
I hope he feels better soon.

peachgreen · 31/03/2019 23:04

Och poor wee thing. Trust your gut, OP - if you're not happy and he's in pain, go back in.

CharlesChickens · 31/03/2019 23:04

We live an hour’s drive from a hospital and after getting seen and waiting for the meds, we drove home. My dd was ( as mentioned above) a little bit better by the time we arrived home . Made me realise the miracle of antibiotics .

Original poster
Iflippinghateplaydoh · 31/03/2019 23:06

Thanks all. Just googled but no eye hospital a&e around here at all.

@namechanged did your dc have orbital or periorbital to have the iv antibiotics?

@bookclub no swabs taken.

2 docs said orbital, then the 3rd said peri. He spoke to consultant who never actually saw my ds and they decided on oral. My worry is his eye wasn't open enough at the time for him to even check his eyeball to ensure that the eye itself looked okay.

OP posts:
Original poster
Iflippinghateplaydoh · 31/03/2019 23:07

@charleschickens did her temp etc all go back to normal quickly also once the antibiotics started working?

OP posts:
ScarlettSahara · 31/03/2019 23:13

OP I used to work as a paediatric registrar-bit rusty now but some children with peri-orbital cellulitis can go downhill very quickly with complications. We always treated with I V antibiotics. I may bea bit rusty since not worked for a while due to poor health & am quite poorly myself today but I honestly would get your little boy back to hospital.

Don’t worry about the staff giving you a hard time-nobody should do that in these circumstances. The cause for POC is not always obvious. I would be concerned about the headache tbh (could be the high temp but could be other causes) so I would urge you to take him in tonight & grab ab overnight bag just in case.

BookClubBlues · 31/03/2019 23:16

My dds temp / lethargy / breathing all went back to normal once ab kicked in.
Please take him back, infections can get serious quickly in little ones.

Redskyandrainbows67 · 31/03/2019 23:22

Take him back. Say he seems worse/no better to you. It’s always better to be safe than sorry.

You just have to think who cares what they think re you going back.

Bunnybigears · 31/03/2019 23:26

I would take him back.

Girlwhowearsglasses · 31/03/2019 23:35

That’s nasty OP.

DS spent three days on iv antibiotics last year in hospital after a horsefly bite got infected. We were told in no uncertain terms that it was to avoid it getting into the eyeball.

The nurses told me they had kids in every week with this: fortunately for DS is ‘‘twas relatively painless for him and he was on the mend after a day - so on the whole boring for him and just getting the theee days of IV out of the way. But if the risks are an infection via the optic nerve leading to meningitis (via blindness) then any treatment is not time wasting!

If he starts to improve I wouldn’t worry but if not get back to the hospital
Get well soon!

pineapplebryanbrown · 31/03/2019 23:40

Mine was diagnosed with peri orbital cellulitis and given a week of iv antibiotics (back and forth to hospital) they appeared to have no particular effect. When the swelling eventually went down i could see a tiny red dot. I think it was a bite, he's very hayfevery and allergic to grass etc.

Original poster
Iflippinghateplaydoh · 31/03/2019 23:48

Just called hospital again as his temp is currently 39.4 despite Nurofen at 7pm and Calpol at 9pm. She said the temperature isn't of concern as he has an infection and the fact I've said his eye is looking less swollen is positive so see how he seems in the morning. Now I do feel like I'm being ott . Will set my alarm and check him overnight

OP posts:
CharlesChickens · 31/03/2019 23:50

My dd did not have a very high temp, just a bit raised, she was noticably more herself by the time we got hime, and a lot better after three doses, the next morning. ( we had gone in there in the evening ).
I agree that the headache alone is enough reason to go back. I hope he is soon improving op.

CharlesChickens · 31/03/2019 23:51

How many doses has he had now op ?

CharlesChickens · 31/03/2019 23:52

I really don’t think you are ott.

Original poster
Iflippinghateplaydoh · 31/03/2019 23:58

He's had 2 doses. They said just to give the 2 today and then as of tomorrow it's 3 x a day for 10 days

OP posts:
pineapplebryanbrown · 31/03/2019 23:59

Just to add my son was completely well apart from a swollen eye.

MoonlitCastle · 01/04/2019 00:03

OP what happened? Hope that your little boy is better?

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