Periorbital Cellulitis Complicating Adenovirus Infection

Sir .—Periorbital (preseptal) cellulitis is a soft-tissue infection often associated with a history of antecedent coryza, trauma, or local skin inflammation. 1 Recent reports emphasize management rather than pathogenesis. The role of sinusitis as a predisposing factor has been controversial, with some authors regarding it as a complication of the process that initiates the cellulitis 2,3 and others implying a direct causation. 1,4 The most frequently encountered pathogens have been Haemophilus influenzae in those patients with an upper respiratory tract infection; staphylococci and streptococci are etiologic with adjacent trauma or skin inflammation. 2 The question of whether or not viruses can predispose to periorbital cellulitis has been raised 5 but, with the exception of Herpesvirus varicellae mentioned in connection with eyelid infection, 3,4 not one known to produce rhinitis has been identified. We encountered a 13-month-old child with pharyngoconjunctival fever caused by type 7a adenovirus in whom cellulitis developed in