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Herpes simplex, herpes zoster and periorbital erythema flares after SARS-CoV-2 vaccination: 4 cases.Annales de Dermatologie Et de... Mar 2022
Topics: COVID-19; COVID-19 Vaccines; Chickenpox; Erythema; Herpes Simplex; Herpes Zoster; Humans; SARS-CoV-2; Vaccination
PubMed: 34711399
DOI: 10.1016/j.annder.2021.07.009 -
BMC Ophthalmology Mar 2022We report a rare case of orbital subperiosteal hematoma associated with frontal and ethmoidal sinusitis. Common concerns involving the orbital subperiosteal space...
BACKGROUND
We report a rare case of orbital subperiosteal hematoma associated with frontal and ethmoidal sinusitis. Common concerns involving the orbital subperiosteal space include abscess, hematoma and tumor.
CASE PRESENTATION
A patient presented to our clinic with periorbital swelling and limited extraocular muscle movement in her left eye. Computed tomography revealed a superior subperiosteal mass with frontal and ethmoidal sinusitis. We diagnosed the patient with subperiosteal hematoma and surgical evacuation was performed via superior orbitotomy. Brown serous discharge was drained and biopsy demonstrated fibrin clots. The final diagnosis was orbital subperiosteal hematoma and the patient was discharged with symptoms resolved.
CONCLUSION
Orbital subperiosteal hematoma is difficult to distinguish from abscess owing to its rarity and similar presentation. Computed tomography is helpful in diagnosis, and surgical evacuation during the early stages is essential to achieving a good outcome.
Topics: Abscess; Ethmoid Sinusitis; Female; Hematoma; Humans; Orbit; Orbital Diseases; Sinusitis
PubMed: 35241018
DOI: 10.1186/s12886-022-02324-y -
International Medical Case Reports... 2022There has been a rise in secondary invasive fungal infections reported in COVID-19 patients globally. We report the first published case of COVID-19 associated...
BACKGROUND
There has been a rise in secondary invasive fungal infections reported in COVID-19 patients globally. We report the first published case of COVID-19 associated rhino-orbital-cerebral mucormycosis in Africa in a newly diagnosed diabetic female who presented with diabetic ketoacidosis (DKA) and discuss the prevalence and risk factors of fungal co-infection with the clinical presentation, diagnosis, and management of mucormycosis in COVID-19.
CASE PRESENTATION
A 39 years old female patient was admitted to ICU with a diagnosis of severe COVID-19 and newly diagnosed diabetes mellitus (DM) with DKA based on HgbA1c of 13.8% and positive RT-PCR. The patient was treated with dexamethasone in line with evidence in the RECOVERY trial and developed right facial and orbital swelling on her second hospital day. Brain MRI showed characteristic peri-sinonasal invasion with central nervous system (CNS) involvement, features suggestive of invasive fungal infection. Despite all medical and surgical treatments including liposomal amphotericin B and debridement, the patient died within 7 days of symptom onset.
CONCLUSION
Clinicians should be aware of the potential for Rhino-Orbital-Cerebral Mucormycosis (ROCM) as a complication of COVID-19, especially in steroid taking diabetics who develop periorbital swelling and sinusitis. Timely diagnosis and multidisciplinary treatment are very critical.
PubMed: 35615254
DOI: 10.2147/IMCRJ.S364591 -
Open Forum Infectious Diseases May 2022Lemierre's syndrome (LS) is a rare and potentially fatal condition that predominantly affects young adults with oropharyngeal infection. is the usual etiology and...
Lemierre's syndrome (LS) is a rare and potentially fatal condition that predominantly affects young adults with oropharyngeal infection. is the usual etiology and classically causes internal jugular vein septic thrombophlebitis, frequently complicated by septic emboli to several organs (most classically to the lungs). Lemierre-like syndrome (LLS) describes the same constellation of symptoms and pathophysiology as Lemierre's syndrome; however, spp. are not the cause, and the source of infection may be nonoropharyngeal. We present a case with an unusual etiology of LLS: a patient with untreated preseptal cellulitis and associated methicillin-resistant (MRSA) bacteremia in the setting of injection drug use. Physical exam revealed tachypnea and rhonchi with severe periorbital and bilateral eyelid edema. Imaging demonstrated bilateral preseptal and orbital cellulitis with thrombosis of both internal jugular veins and bilateral pulmonary cavitary lesions consistent with septic pulmonary emboli. She was managed with anticoagulation and parenteral antibiotics. To our knowledge, this is the first case of LLS originating from preseptal cellulitis without evidence of preceding pharyngitis. While facial and orbital infections are rare etiologies of LLS, the potentially devastating sequelae of LLS warrant its inclusion in differential diagnoses.
PubMed: 35531375
DOI: 10.1093/ofid/ofac143 -
Medical Principles and Practice :... 2020In this study, we describe ocular dirofilariasis in Bulgaria. (Observational Study)
Observational Study
OBJECTIVES
In this study, we describe ocular dirofilariasis in Bulgaria.
MATERIALS AND METHODS
We studied 7 patients with a subconjunctival or periorbital form of Dirofilaria repens infection during 2010-2019. Morphological, serological, and paraclinical diagnostic methods were used.
RESULTS
The patients (6 females, 1 male) were aged between 23 and 72 years. In 3 patients, subcutaneous nodules were detected in the area of the upper eyelid, in 1 patient the location was suborbital. In 3 other patients, a subconjunctival location was found. All patients were cured definitively by removal of the larva, without etiologic treatment.
CONCLUSION
The most reliable and easily accessible diagnostic method is morphological analysis by microscopy of histological preparations of the parasite. In dirofilariasis, ocular location is the most common in humans, and it deserves special attention of clinicians.
Topics: Adult; Aged; Bulgaria; Dirofilariasis; Eye Diseases; Female; Humans; Male; Middle Aged
PubMed: 32460293
DOI: 10.1159/000508960 -
PloS One 2023Periorbital and orbital cellulitis are inflammatory conditions of the eye that can be difficult to distinguish using clinical examination alone. Computer tomography (CT)...
BACKGROUND
Periorbital and orbital cellulitis are inflammatory conditions of the eye that can be difficult to distinguish using clinical examination alone. Computer tomography (CT) scans are often used to differentiate these two infections and to evaluate for complications. Orbital ultrasound (US) could be used as a diagnostic tool to supplement or replace CT scans as the main diagnostic modality. No prior systematic review has evaluated the diagnostic test accuracy (DTA) of ultrasound compared to cross-sectional imaging.
OBJECTIVE
To conduct a systematic review of studies evaluating the DTA of orbital ultrasound compared with cross-sectional imaging, to diagnose orbital cellulitis.
METHODS
MEDLINE, EMBASE, CENTRAL, and Web of Science were searched from inception to August 10, 2022. All study types were included that enrolled patients of any age with suspected or diagnosed orbital cellulitis who underwent ultrasound and a diagnostic reference standard (i.e., CT or magnetic resonance imaging [MRI]). Two authors screened titles/abstracts for inclusion, extracted data, and assessed the risk of bias.
RESULTS
Of the 3548 studies identified, 20 were included: 3 cohort studies and 17 case reports/series. None of the cohort studies directly compared the diagnostic accuracy of ultrasound with CT or MRI, and all had high risk of bias. Among the 46 participants, diagnostic findings were interpretable in 18 (39%) cases which reported 100% accuracy. We were unable to calculate sensitivity and specificity due to limited data. In the descriptive analysis of the case reports, ultrasound was able to diagnose orbital cellulitis in most (n = 21/23) cases.
CONCLUSION
Few studies have evaluated the diagnostic accuracy of orbital ultrasound for orbital cellulitis. The limited evidence based on low quality studies suggests that ultrasound may provide helpful diagnostic information to differentiate orbital inflammation. Future research should focus studies to determine the accuracy of orbital US and potentially reduce unnecessary exposure to radiation.
Topics: Humans; Orbital Cellulitis; Ultrasonography; Magnetic Resonance Imaging; Radionuclide Imaging; Diagnostic Tests, Routine; Sensitivity and Specificity
PubMed: 37410730
DOI: 10.1371/journal.pone.0288011 -
Case Reports in Ophthalmology 2023Orbital cellulitis is a serious, life-threatening infection, typically in paediatric patients, and its bilateral presentation in adults is atypic. We present an unusual...
Orbital cellulitis is a serious, life-threatening infection, typically in paediatric patients, and its bilateral presentation in adults is atypic. We present an unusual bilateral manifestation of orbital cellulitis and abscess, caused by Enterococci in an adult patient. is an extremely rare cause of orbital inflammation and we found three published case reports only, all of which are unilateral and seen in children. A 51-year-old male presented with 1-week history of pyrexia, painful proptosis, periorbital swelling, and low vision of both eyes. He was diagnosed with bilateral orbital cellulitis and was treated with empiric antibiotic medication for 8 days, but symptoms persisted. MRI showed bilateral intra- and extraconal fluid-intensity collections. Microbiology was taken from the orbit and revealed invasion. Pus collections were drained for 1 week. Systemic and intraorbital antibiotics were administered. The patient recovered and vision returned to normal. This is a rare case of bilateral orbital cellulitis and abscesses with invasive infection. infection of the orbit is unusual and should be considered, especially if patient does not respond to empiric antibiotic therapies.
PubMed: 37901623
DOI: 10.1159/000533608 -
Biomedical Journal Feb 2020Necrotizing fasciitis (NF) is uncommon but potentially lethal when it is associated with systemic disorders. We report a case of odontogenic NF in a patient with... (Review)
Review
Necrotizing fasciitis (NF) is uncommon but potentially lethal when it is associated with systemic disorders. We report a case of odontogenic NF in a patient with uncontrolled diabetes mellitus. The patient was referred on day 10 since the onset of odontogenic NF. Protective tracheostomy, local facial-cervical fasciotomy were conducted and broadspectrum antibiotics were given, subsequent serial surgical drainage and debridement were performed in theater. Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumonia were isolated. Five staged debridements were performed to the targeted anatomic regions thus reducing surgical time and blood loss. The patient survived the acute infection and received subsequent reconstruction. Cervical NF with descending mediastinitis and periorbital NF is associated with high mortality rates. This is the only known report of an adult who survived NF affecting entire scalp, periorbital, cervical, and thoracic region. Early diagnosis and staged surgical planning minimize morbidity and mortality from NF.
Topics: Anti-Bacterial Agents; Diabetes Mellitus; Fasciitis, Necrotizing; Humans; Klebsiella Infections; Male; Middle Aged; Neck; Staphylococcal Infections
PubMed: 32200961
DOI: 10.1016/j.bj.2019.08.002 -
Bone Dec 2021Fibrous dysplasia (FD) is a mosaic skeletal disorder in which the craniofacial bones are commonly affected. Normal structures are replaced by expansile, highly vascular,... (Review)
Review
Fibrous dysplasia (FD) is a mosaic skeletal disorder in which the craniofacial bones are commonly affected. Normal structures are replaced by expansile, highly vascular, fibro-osseous tissue. The typical clinical course is a gradual, asymptomatic expansion of the osseous structures. However, in the periorbital region, even minor structural changes may cause functional impairment, such as diplopia and hyposmia. Furthermore, rapidly evolving secondary lesions, such as fluid-filled cysts, can sometimes develop. In the midface and periorbital regions, such acute change may be associated with severe pain, vision loss, and, signs of inflammation. Here we describe three patients with craniofacial FD who presented with recurrent episodes of periorbital inflammation mimicking orbital cellulitis. All presented with pain, edema, erythema, and warmth, with varying degrees of functional impairment. On imaging, all had cystic changes in the FD lesion, including two with aneurysmal bone cysts (ABCs). Two were initially diagnosed with periorbital cellulitis and treated with antibiotics; in two, the radiographic findings were misdiagnosed as osteomyelitis. Recurrent episodes were recognized as not infectious and effectively managed with corticosteroids. Given the vascular nature of FD and the association of ABCs, it is likely the findings in these patients represent inflammation associated with vascular leak in the relatively confined space of the tissues overlying the periorbital bones. Recognition of this entity can lead to more rapid and appropriate treatment.
Topics: Bone and Bones; Craniofacial Fibrous Dysplasia; Fibrous Dysplasia of Bone; Humans; Inflammation; Osteomyelitis
PubMed: 34425287
DOI: 10.1016/j.bone.2021.116157 -
Indian Journal of Ophthalmology Sep 2023Ophthalmic dirofilariasis is an uncommon zoonotic parasitic infection caused by species of Dirofilaria, a dog tapeworm that is transmitted to human by mosquitoes. Man is...
BACKGROUND
Ophthalmic dirofilariasis is an uncommon zoonotic parasitic infection caused by species of Dirofilaria, a dog tapeworm that is transmitted to human by mosquitoes. Man is a dead-end host for the parasite. Ophthalmic involvement is rare and includes periorbital, subconjunctival, subtenon, and intra-ocular involvement. We report the removal of a subconjunctival worm and identification by light microscopy (LM) and scanning electron microscopy (SEM).
PURPOSE
: A 62-year-old female presented with complaints of redness, discharge, and foreign body sensation with difficulty in opening eyes in the left eye for the last 3 days. The patient is a non-vegetarian. On examination, her best corrected visual acuity in both eyes was 20/20. On slit lamp examination, there was a long, thin, round, coiled white subconjunctival live worm in the left eye superiorly. The rest of anterior segment evaluation, intra-ocular pressure, and fundus was normal in both eyes. The parasite was removed under local anesthesia from subconjunctival space [Video]. External surface morphology under LM revealed fine transverse cuticular striations with tapered cephalic and caudal ends. Uterus was long and coiled with indistinguishable masses inside. The finding was also confirmed by SEM.
SYNOPSIS
A subconjuctival parasite was removed and identified as Dirofilaria repens by characteristic LM and SEM findings.
HIGHLIGHT
Dirofilaria species may lodge in many tissues of human bodies including eye and adnexa. Dirofilaria is a natural parasite of carnivorous animals, mostly dogs, cats, and foxes. The most common mode of transmission to human is usually by bite of mosquitoes like Culex and Aedes, which are considered as vectors, and it is often thought that parasitemia is because of accidental conduction. Simple surgical removal of the worm is curative. After removal, the worm should be visualized directly under LM. All the internal structures of the transparent worm could be seen and compared with those under SEM.
Topics: Humans; Female; Male; Animals; Dogs; Middle Aged; Microscopy, Electron, Scanning; Parasites; Mosquito Vectors; Eye; Face
PubMed: 37602631
DOI: 10.4103/IJO.IJO_830_23