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Current Opinion in Ophthalmology Sep 2019This study is a review of recent literature in the diagnosis and management of preseptal cellulitis, orbital cellulitis and dacryocystitis, including causative... (Review)
Review
PURPOSE OF REVIEW
This study is a review of recent literature in the diagnosis and management of preseptal cellulitis, orbital cellulitis and dacryocystitis, including causative organisms, diagnosis and medical or surgical therapy and potential complications.
RECENT FINDINGS
Advances in vaccination against Haemophilus influenzae B have resulted in a shift in the most common causative organisms of preseptal and orbital cellulitis. Management of orbital cellulitis has been advanced by adjuvant corticosteroids, and subperiosteal abscess volumes of more than 1250 ml has been shown as predictive for requiring potential surgical intervention.
SUMMARY
Periorbital infections require prompt evaluation and management. Although the infectious organisms in both preseptal and orbital cellulitis include Staphylococcus/Streptococcus species, management may differ significantly on the basis of the nidus of infection, presenting signs and symptoms, and response to initial medical management.
Topics: Abscess; Anti-Bacterial Agents; Bacteria; Child; Child, Preschool; Dacryocystitis; Eye Infections, Bacterial; Female; Humans; Male; Orbital Cellulitis
PubMed: 31261188
DOI: 10.1097/ICU.0000000000000589 -
Indian Journal of Ophthalmology May 2023After the global COVID-19 pandemic, there has been an alarming concern with the monkeypox (mpox) outbreak, which has affected more than 110 countries worldwide.... (Review)
Review
After the global COVID-19 pandemic, there has been an alarming concern with the monkeypox (mpox) outbreak, which has affected more than 110 countries worldwide. Monkeypox virus is a doublestranded DNA virus of the genus Orthopox of the Poxviridae family, which causes this zoonotic disease. Recently, the mpox outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern (PHEIC). Monkeypox patients can present with ophthalmic manifestation and ophthalmologists have a role to play in managing this rare entity. Apart from causing systemic involvement such as skin lesions, respiratory infection and involvement of body fluids, Monkeypox related ophthalmic disease (MPXROD) causes varied ocular manifestations such as lid and adnexal involvement, periorbital and lid lesion, periorbital rash, conjunctivitis, blepharocounctivitis and keratitis. A detailed literature review shows few reports on MPXROD infections with limited overview on management strategies. The current review article is aimed to provide the ophthalmologist with an overview of the disease with a spotlight on ophthalmic features. We briefly discuss the morphology of the MPX, various modes of transmission, an infectious pathway of the virus, and the host immune response. A brief overview of the systemic manifestations and complications has also been elucidated. We especially highlight the detailed ophthalmic manifestations of mpox, their management, and prevention of vision threatening sequelae.
Topics: Humans; COVID-19; Mpox (monkeypox); Pandemics; Eye; Body Fluids
PubMed: 37203020
DOI: 10.4103/ijo.IJO_2032_22 -
Journal of Cosmetic and Laser Therapy :... Nov 2020Soft tissue augmentation with injectable fillers is increasingly being performed, and providers must be prepared to understand and treat complications. Periorbital skin... (Review)
Review
Soft tissue augmentation with injectable fillers is increasingly being performed, and providers must be prepared to understand and treat complications. Periorbital skin presents unique challenges due to its thin nature, easily evident pigmentary and textural irregularities, and anatomical considerations including vasculature and subcutaneous layers. The most common complications of infraorbital filler include ecchymosis, malar edema, blue-gray hue, and contour irregularities. Uncommon complications include infection and biofilm formation, skin necrosis, and blindness. This purpose of this review is to highlight the infraorbital anatomy, complications of filler injection in this region, and techniques to avoid these complications.
Topics: Cosmetic Techniques; Dermal Fillers; Edema; Face; Humans; Hyaluronic Acid
PubMed: 33794721
DOI: 10.1080/14764172.2021.1909067 -
International Medical Case Reports... 2019Proptosis in children with acute-onset accompanied by signs of inflammation is commonly caused by orbital cellulitis, however, the possibility of rhabdomyosarcoma should... (Review)
Review
INTRODUCTION
Proptosis in children with acute-onset accompanied by signs of inflammation is commonly caused by orbital cellulitis, however, the possibility of rhabdomyosarcoma should always be considered by the clinician. This is a case report of a five-year-old boy presenting with an acute-onset of proptosis without a history of trauma and systemic infection. Our clinical differential diagnosis included orbital cellulitis and orbital rhabdomyosarcoma.
PURPOSE
To report a case of orbital cellulitis that clinically and radiologically mimics rhabdomyosarcoma.
CASE PRESENTATION
A five-year-old boy presented with rapid-onset proptosis, periorbital edema, pain and visual loss in the left eye for two weeks without a history of trauma, upper respiratory tract infection, sinusitis or immunosuppression. Our clinical differential diagnosis includes rhabdomyosarcoma and orbital cellulitis. Complete blood count reveals a leukocytosis. Multislice computed tomography (MSCT) scan shows lesions involving the lateral orbit and the retro bulbar space. Antibiotics combination and adjunct anti-inflammatory intravenously shows excellent clinical resolution.
CONCLUSIONS
The study demonstrates difficulty in differentiating acute orbital cellulitis from rhabdomyosarcoma based on clinical findings. In addition, the case highlights that antibiotic combination of cephalosporin and aminoglycosides together with an adjuvant corticosteroid as an anti-inflammatory was effective in the case of acute orbital cellulitis.
PubMed: 31692563
DOI: 10.2147/IMCRJ.S201678 -
Cureus Nov 2022Management of psychiatric disorders in high-risk cardiac patients often requires difficult decision making when it comes to acceptable medication side effects. We...
Management of psychiatric disorders in high-risk cardiac patients often requires difficult decision making when it comes to acceptable medication side effects. We present the case report of a 28-year-old female with a history of generalized anxiety disorder (GAD), major depressive disorder (MDD), intravenous heroin use disorder, and prior tricuspid valve replacement who presented to the hospital with signs and symptoms of sepsis. She was found to have corrected QT interval (QTc) prolongation and infective endocarditis with blood cultures positive for . Due to QTc prolongation, her home medication of citalopram was discontinued in favor of escitalopram. Within 24 hours of administration, the patient experienced angioedema with periorbital swelling, lip swelling, and urticaria of the face and arms which was resolved with intravenous (IV) diphenhydramine. In this case report, we present what we believe to be the first recorded case of escitalopram-induced angioedema in a patient without a past medical history of hereditary angioedema (HAE), and how pharmacogenomic testing influenced antidepressant medication selection.
PubMed: 36540519
DOI: 10.7759/cureus.31600 -
Open Forum Infectious Diseases May 2019A traveler presented with a furuncular skin abscess and periorbital edema. A larva was surgically removed from the abscess and identified as a larva of . Myiasis caused...
A traveler presented with a furuncular skin abscess and periorbital edema. A larva was surgically removed from the abscess and identified as a larva of . Myiasis caused by is called Lund's fly myiasis and only rarely is reported in humans. After disinfection, the remaining lesion healed without further intervention and the edema resolved.
PubMed: 31139677
DOI: 10.1093/ofid/ofz204 -
Ophthalmic Plastic and Reconstructive...Three patients presented with periorbital swelling, pain with extraocular movements, and binocular diplopia 1-4 days after receiving an mRNA Coronavirus Infectious...
Three patients presented with periorbital swelling, pain with extraocular movements, and binocular diplopia 1-4 days after receiving an mRNA Coronavirus Infectious Disease-19 (COVID-19) vaccine (BNT162b2, Pfizer/BioNTech; mRNA-1273, Moderna). All patients had a normal afferent function, unilateral limitation of extraocular motility, proptosis, and periorbital inflammation. Neuroimaging of the orbits with contrast revealed inflammation and enlargement of extraocular muscles in 2 cases and the lacrimal gland in 1 case. In all 3 cases, an extensive infectious and inflammatory laboratory work-up was unremarkable and signs and symptoms of orbital inflammation rapidly improved to complete resolution after treatment with high-dose oral prednisone. This is the first reported series of orbital inflammation occurring shortly after administration of the COVID-19 vaccine. Clinicians may consider an inflammatory postvaccine etiology as an alternative to presumed idiopathic diagnosis in such cases.
Topics: BNT162 Vaccine; COVID-19; COVID-19 Vaccines; Communicable Diseases; Humans; Inflammation; Vaccination
PubMed: 35323144
DOI: 10.1097/IOP.0000000000002161 -
Indian Journal of Dermatology 2015Dirofilariasis is a parasitic infection transmitted by mosquitoes from domestic and wild animals. Humans accidentally get infected and can present with a lung nodule,...
Dirofilariasis is a parasitic infection transmitted by mosquitoes from domestic and wild animals. Humans accidentally get infected and can present with a lung nodule, subcutaneous mass or an ocular lesion which will be either subconjunctival or periorbital. Proper microbiological and histopathological examinations aid in proper diagnosis. Herein, we present a case report of a 64-year-old female patient from Kerala with an infraorbital mass diagnosed as dirofilariasis.
PubMed: 26288429
DOI: 10.4103/0019-5154.160513 -
The Eurasian Journal of Medicine Jun 2017Zika virus (ZIKV) is an arbovirus of the genus, and it has an envelope and a single RNA molecule. In early 2016, the World Health Organization declared ZIKV infection... (Review)
Review
Zika virus (ZIKV) is an arbovirus of the genus, and it has an envelope and a single RNA molecule. In early 2016, the World Health Organization declared ZIKV infection to be an emerging global health threat. The major transmission route of the virus to humans is mosquitoes. ZIKV can be transmitted between humans by transplacental, perinatal, and sexual routes and via blood and body fluids. ZIKV infection usually results in a mild and self-limiting disease with low-grade fever, conjunctivitis, and periorbital edema. Neurological complications such as Guillain-Barré syndrome, meningoencephalitis, acute disseminated encephalomyelitis, acute myelitis, and transverse myelitis have been reported during ZIKV infection. Intrauterine and congenital ZIKV infections have strong teratogenic effects on the fetus. Intrauterine or congenital ZIKV infection can lead to microcephaly, ocular anomalies (such as macular atrophy, pigment mottling, and optic nerve anomalies), and cardiac anomalies (such as atrial or ventricular septal defect). Calcification in the brain between the cortical and subcortical areas, ventriculomegaly, cerebellar hypoplasia, corpus callosum hypoplasia, cortical/subcortical atrophy, delayed myelination, enlarged cisterna magna, and craniofacial disproportion have been reported as brain development defects. ZIKV infection usually results in a mild disease, and it does not require specific therapy. However, complications of infection during the early period of life are serious. Thus, many drugs have been investigated, and vaccine development studies have been conducted to prevent ZIKV infection. Vector control and personal protection from mosquito-borne transmission are important for decreasing the prevalence of ZIKV infection. In particular, pregnant residents or travelers to endemic areas should be carefully protected against mosquito-borne transmission.
PubMed: 28638259
DOI: 10.5152/eurasianjmed.2017.17147 -
The American Journal of Emergency... Jun 2023Orbital cellulitis is an uncommon but serious condition that carries with it a potential for significant morbidity. (Review)
Review
INTRODUCTION
Orbital cellulitis is an uncommon but serious condition that carries with it a potential for significant morbidity.
OBJECTIVE
This review highlights the pearls and pitfalls of orbital cellulitis, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
DISCUSSION
Orbital cellulitis refers to infection of the globe and surrounding soft tissues posterior to the orbital septum. Orbital cellulitis is typically caused by local spread from sinusitis but can also be caused by local trauma or dental infection. It is more common in pediatric patients compared to adults. Emergency clinicians should first assess for and manage other critical, sight-threatening complications such as orbital compartment syndrome (OCS). Following this assessment, a focused eye examination is necessary. Though orbital cellulitis is primarily a clinical diagnosis, computed tomography (CT) of the brain and orbits with and without contrast is critical for evaluation of complications such as abscess or intracranial extension. Magnetic resonance imaging (MRI) of the brain and orbits with and without contrast should be performed in cases of suspected orbital cellulitis in which CT is non-diagnostic. While point-of-care ultrasound (POCUS) may be useful in differentiating preseptal from orbital cellulitis, it cannot exclude intracranial extension of infection. Management includes early administration of broad-spectrum antibiotics and ophthalmology consultation. The use of steroids is controversial. In cases of intracranial extension of infection (e.g., cavernous sinus thrombosis, abscess, or meningitis), neurosurgery should be consulted.
CONCLUSION
An understanding of orbital cellulitis can assist emergency clinicians in diagnosing and managing this sight-threatening infectious process.
Topics: Adult; Child; Humans; Orbital Cellulitis; Abscess; Prevalence; Orbit; Ophthalmology; Anti-Bacterial Agents; Cellulitis; Orbital Diseases; Retrospective Studies
PubMed: 36893591
DOI: 10.1016/j.ajem.2023.02.024