Paediatric infections: orbital cellulitis: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: orbital cellulitis

Sample item

A 6-year-old with sinusitis has fever, a swollen red eyelid and is unwilling to look sideways. Which finding most reliably indicates orbital (postseptal) rather than preseptal cellulitis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Proptosis with painful restricted eye movements

In orbital cellulitis infection lies behind the orbital septum, producing proptosis, pain on eye movement, ophthalmoplegia and sometimes reduced vision. Preseptal cellulitis is limited to the eyelid. Orbital disease needs contrast CT and intravenous antibiotics because of the risk of abscess and intracranial spread.

Option by option

  • A. Proptosis with painful restricted eye movements (correct)

    Correct. Proptosis and painful ophthalmoplegia show postseptal involvement.

  • B. Eyelid swelling and warmth

    Lid swelling and warmth occur in both preseptal and orbital cellulitis.

  • C. Fever and leucocytosis

    Fever and a raised white count do not distinguish depth of infection.

  • D. Conjunctival redness with discharge

    Conjunctival changes are non-specific and occur in both.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Proptosis with painful restricted eye movements. In orbital cellulitis infection lies behind the orbital septum, producing proptosis, pain on eye movement, ophthalmoplegia and sometimes reduced vision.

Why is "Eyelid swelling and warmth" not the answer?

Lid swelling and warmth occur in both preseptal and orbital cellulitis.

Why is "Fever and leucocytosis" not the answer?

Fever and a raised white count do not distinguish depth of infection.

Why is "Conjunctival redness with discharge" not the answer?

Conjunctival changes are non-specific and occur in both.

What concept does this question test?

It tests Paediatric infections: orbital cellulitis in Pediatrics. Preseptal cellulitis is limited to the eyelid. Orbital disease needs contrast CT and intravenous antibiotics because of the risk of abscess and intracranial spread.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: orbital cellulitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.