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Orbit (Amsterdam, Netherlands) Oct 2022A 6-month-old female presented with bilateral periorbital edema for 7 days. Laboratory testing was significant for active SARS-CoV-2 infection. Neuroimaging demonstrated...
A 6-month-old female presented with bilateral periorbital edema for 7 days. Laboratory testing was significant for active SARS-CoV-2 infection. Neuroimaging demonstrated soft tissue changes within the bilateral orbits and enlargement of the bilateral lacrimal glands. Although the patient initially improved with corticosteroid treatment, she later returned with recurrent left periorbital and eyelid edema. Orbital biopsy was performed and demonstrated findings in the lacrimal gland and the adjacent fibroconnective tissues that are similar to those of prior lung specimens seen in SARS-CoV-2 patients. Final diagnosis was bilateral orbital inflammation with features presumed secondary to SARS-CoV-2 infection. To the best of our knowledge, this is one of the first reports to document bilateral orbital inflammation as a sign of SARS-CoV-2 infection in the pediatric population with the associated pathological findings.
Topics: COVID-19; Child; Edema; Female; Humans; Infant; Inflammation; Lacrimal Apparatus; SARS-CoV-2
PubMed: 33874837
DOI: 10.1080/01676830.2021.1914670 -
The Journal of the American Osteopathic... Feb 1992Bacterial infections of the periorbital and orbital tissues range in severity from minor to life-threatening. Preseptal (periorbital) cellulitis is more common than... (Review)
Review
Bacterial infections of the periorbital and orbital tissues range in severity from minor to life-threatening. Preseptal (periorbital) cellulitis is more common than orbital cellulitis and occurs quite frequently in children. A history of antecedent trauma or upper respiratory tract infection is present in more than half of all cases. Evaluation by computed tomography scans is an indispensable part of the diagnostic procedure. All cultures should be obtained before institution of antibiotic therapy. Initial therapy should begin with administration of broad-spectrum antibiotics with adjustments made in response to positive culture results. Response to antibiotics is usually prompt and the incidence of complications is low. If clinical improvement is slow, surgery should be performed early in the course of the disease to minimize the potential for significant complications such as cavernous sinus thrombosis.
Topics: Bacterial Infections; Child; Humans; Orbital Diseases
PubMed: 1544826
DOI: No ID Found -
Journal of the Neurological Sciences Mar 2016Septic cerebral venous sinus thrombosis, once a common and deadly disease, has fortunately become rare now. Not only that the incidence has fallen significantly after... (Review)
Review
Septic cerebral venous sinus thrombosis, once a common and deadly disease, has fortunately become rare now. Not only that the incidence has fallen significantly after the antibiotic era, the morbidity and mortality has also decreased substantially. Cavernous sinus thrombosis is by far the commonest form of septic cerebral venous sinus thrombosis. Due to its rare occurrence, a lot of current generation clinicians have not encountered the entity in person. Despite all the advances in diagnostic modalities, a high index of clinical suspicion remains the mainstay in prompt diagnosis and management of this potentially lethal condition. Keeping this in view, the authors have reviewed the subject including the old literature and have summarized the current approach to diagnosis and management. Septic cavernous thrombosis is a fulminant disease with dramatic presentation in most cases comprised of fever, periorbital pain and swelling, associated with systemic symptoms and signs. The preceding infection is usually in the central face or paranasal sinuses. The disease rapidly spreads to contralateral side and if remains undiagnosed and untreated can result in severe complications or even death. Prompt diagnosis using radiological imaging in suspected patient, early use of broad spectrum antibiotics, and judicial use of anticoagulation may save the life and prevent disability. Surgery is used only to treat the nidus of infection.
Topics: Humans; Infections; Sepsis; Sinus Thrombosis, Intracranial
PubMed: 26944152
DOI: 10.1016/j.jns.2016.01.035 -
International Journal of Pediatric... Apr 2012Recurrent periorbital cellulitis is a rare complication of sinus disease. We present a 4-month-old boy with bilateral recurrent periorbital cellulitis and radiological... (Review)
Review
Recurrent periorbital cellulitis is a rare complication of sinus disease. We present a 4-month-old boy with bilateral recurrent periorbital cellulitis and radiological evidence of bilateral bony dehiscence of the lamina papyracea. To our knowledge, this is the youngest documented presentation of recurrent periorbital cellulitis. As well, only unilateral cases have been reported in the past. In addition to the clinical case report, we reviewed the current literature available regarding recurrent periorbital cellulitis.
Topics: Cellulitis; Humans; Infant; Male; Orbital Diseases; Paranasal Sinuses; Recurrence
PubMed: 22336174
DOI: 10.1016/j.ijporl.2012.01.024 -
Journal of Paediatrics and Child Health 2005To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA).
OBJECTIVE
To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA).
DESIGN
Retrospective hospital-based study in a tertiary children's hospital.
METHODS
Clinical data were reviewed on all children classified as having SDE or BA for 10.75 years from 1 January 1992 to 31 August 2003 at the Royal Alexandra Hospital for Children, Sydney, Australia.
RESULTS
Forty-six children with intracranial suppuration were identified: 26 had BA, 16 had SDE and four children had both SDE and BA. Significant differences between SDE and BA were that: sinusitis was a predisposing factor for SDE (P = 0.01), Streptococcus milleri was the main organism isolated in SDE (P = 0.02), periorbital oedema (P = 0.005) and photophobia (P = 0.02) were clinical features specifically associated with SDE, and 75% of multiple abscesses were in females (P = 0.005). The age distribution of SDE was biphasic, with peaks at <2 years and >7 years. Cases of BA peaked at age 9-11 years. Forty-eight per cent of all children were between 9 and 13 years old; 20% were <1 year old. All the children with SDE and BA were aged 1 year or less. Three of the 46 children died, all with BA. Eighteen (39.1%) returned to normal and 25 (54.3%) had neurological complications. Neurological complications were more common in the BA group.
CONCLUSION
The mortality rate of intracranial suppuration is low, but morbidity remains high. A high degree of suspicion is needed to diagnose and treat intracranial infections early.
Topics: Adolescent; Age Factors; Anti-Bacterial Agents; Brain Abscess; Child; Child, Preschool; Empyema, Subdural; Female; Fever; Headache; Humans; Infant; Infant, Newborn; Male; Prognosis; Retrospective Studies; Sinusitis; Staphylococcal Infections; Staphylococcus aureus; Streptococcus milleri Group; Streptococcus pneumoniae; Suppuration; Treatment Outcome; Vomiting
PubMed: 16150069
DOI: 10.1111/j.1440-1754.2005.00693.x -
Seminars in Respiratory Infections Mar 1995Acute sinusitis is one of the most commonly observed entities in clinical practice. Despite the frequency of the disease, diagnosis and therapy often remain empiric.... (Review)
Review
Acute sinusitis is one of the most commonly observed entities in clinical practice. Despite the frequency of the disease, diagnosis and therapy often remain empiric. Most cases are secondary to sinus ostia obstruction associated with the common cold or allergies. Maxillary sinusitis is most common. Because of the proximity of vital anatomic structures and venous drainage systems, serious complications frequently arise from sphenoid, frontal, and ethmoid sinusitis. Clinical signs and symptoms most helpful in the diagnosis of maxillary sinusitis are the presence of a maxillary toothache, lack of improvement with decongestants, a purulent nasal discharge, cough, purulent secretions observed on nasal examination, abnormal transillumination, and sinus tenderness. Plain film radiographs are helpful, but do not adequately visualize the anterior ethmoid sinuses. Computed tomography provides superior visualization, but cost remains prohibitive for routine cases. Most maxillary sinusitis in adults is secondary to Streptococcus pneumoniae or Hemophilus influenzae. Moroxella catarrhalis is common in children. Staphylococcus aureus is observed more frequently in frontal or sphenoid disease. Most patients with acute sinusitis are treated without microbiological diagnosis and respond well to commonly used oral antimicrobials with activity against the usual pathogens. Complications of sinusitis include meningitis, periorbital infections, subdural empyema, epidural abscess, brains abscess, cavernous sinus thrombosis, and osteomyelitis.
Topics: Acute Disease; Anti-Bacterial Agents; Bacterial Infections; Humans; Maxillary Sinusitis; Sinusitis
PubMed: 7761709
DOI: No ID Found -
International Ophthalmology Dec 2018
Topics: Actinomycosis; Adult; Diagnosis, Differential; Eye Infections, Bacterial; Gram-Positive Bacterial Infections; Humans; Male; Skin Neoplasms; Staphylococcal Infections; Staphylococcus aureus
PubMed: 29181765
DOI: 10.1007/s10792-017-0751-8 -
Orbit (Amsterdam, Netherlands) Aug 2023Periorbital non-tuberculous mycobacterium (NTM) infections are uncommon. To the best of our knowledge, NTM infection as a complication following Müller's...
Periorbital non-tuberculous mycobacterium (NTM) infections are uncommon. To the best of our knowledge, NTM infection as a complication following Müller's muscle-conjunctival resection (MMCR) surgery has not been reported before. We report a case of left upper lid infection following MMCR surgery. A 61-year-old lady presented with left upper lid swelling and nodular mass 4 weeks after bilateral MMCR surgery for aponeurotic ptosis. Past medical and ocular history include systemic lupus erythematosus (SLE), chronic hepatitis B infection, bilateral cataract operation done 14 years ago and right eye Fuch's dystrophy with Descemet stripping automated endothelial keratoplasty done 3 years ago. She was initially treated with topical and oral antibiotics, as well as repeated incision and curettage and intralesional steroid injection with limited improvement. Seven months post-MMCR, repeated biopsy and nodule debulking were performed. Biopsy revealed granulomatous inflammation with mycobacterial infection and PCR identified . A total of 6 months course of combination systemic antibiotics were given, with good response. Limited blepharoplasty with repeat nodular excision was performed 15 months after the initial MMCR surgery, and biopsy culture and PCR were both negative. No relapse of symptoms was noted and good lid height was maintained at 30 months of follow-up. Management of periorbital NTM infections can be challenging. Clinicians should consider early diagnostic workup with mycobacterial culture and PCR in suspicious cases, followed by prompt initiation of empiric treatment with systemic macrolides. A combination of surgical excision of nodules and prolonged systemic antimicrobial treatment is needed for complete organism eradication.
Topics: Female; Humans; Middle Aged; Eyelids; Conjunctiva; Blepharoptosis; Blepharoplasty; Oculomotor Muscles; Mycobacterium Infections, Nontuberculous; Retrospective Studies
PubMed: 35073223
DOI: 10.1080/01676830.2022.2025856 -
The Journal of Infection May 2002Fungal infections of the skin and deeper tissues of the periorbital region are quite rare. We report a case of a localized, deep periorbital necrotizing Fusarium...
Fungal infections of the skin and deeper tissues of the periorbital region are quite rare. We report a case of a localized, deep periorbital necrotizing Fusarium infection in an otherwise healthy, elderly lady. Since the clinical features and histopathological findings of Fusarium infection are by no means characteristic, the definitive diagnosis was achieved with the help of microbiological examination of cultured organisms. A combined medical and surgical therapy led to adequate control of infection. To conclude, localized, deep periorbital necrotizing soft tissue infection by Fusarium in an immunocompetent lady is not reported in literature. One should have a high index of suspicion for emerging fungal pathogens in the differential diagnosis of necrotizing orbital or adnexal conditions, even in an immunocompetent patient. The histologic findings of septate, branching hyphae and vascular invasion cannot distinguish Fusarium species from various other moulds such as Aspergillus species; microbiologic studies are essential for confirming the diagnosis.
Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Cataract; Clotrimazole; Communicable Diseases, Emerging; Eye Infections, Fungal; Female; Fusarium; Humans; Immunocompetence; Lens Implantation, Intraocular; Middle Aged
PubMed: 12099730
DOI: 10.1053/jinf.2002.1005 -
The Indian Journal of Medical Research Nov 2020
Topics: Fasciitis, Necrotizing; Humans; Streptococcal Infections
PubMed: 35345130
DOI: 10.4103/ijmr.IJMR_2070_19