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Indian Journal of Ophthalmology Jul 2022
Topics: Humans; Orbital Cellulitis; Orbital Neoplasms; Rhabdomyosarcoma
PubMed: 35791230
DOI: 10.4103/ijo.IJO_79_22 -
Case Reports in Ophthalmology 2022A 72-year-old male patient was referred to our outpatient clinic with a painful left eye protrusion accompanied by marked conjunctival chemosis and external...
A 72-year-old male patient was referred to our outpatient clinic with a painful left eye protrusion accompanied by marked conjunctival chemosis and external ophthalmoplegia being progressed despite topical and oral antibiotic therapy. He developed ocular symptoms 9 days after receiving his second SARS-CoV-2 vaccine (VeroCell). Of note, in previous history, 2 weeks after the first dose of the COVID-19 vaccine, he also developed a life-threatening laryngeal oedema treated at an emergency care unit. MRI of the orbit excluded pansinusitis as possible origin of the orbital cellulitis, and repeated COVID-19 antigen and antibody PCR tests were negative during his hospitalization. On the next day after his admittance, parenteral dexamethasone 250 mg/die treatment was commenced resulting in a quick and complete resolution of the symptoms. Due to the facts regarding this case, such as the temporal coincidence and the lack of respective comorbidity, there might be a causative relationship between the vaccination and the presented orbital cellulitis. To the best of our knowledge, this is the first report on orbital cellulitis as a possible ocular adverse event following COVID-19 vaccination.
PubMed: 35611007
DOI: 10.1159/000523803 -
Case Reports in Ophthalmology 2022Hematic pseudocysts are fibrous, nonepithelial lined capsules containing blood byproducts that typically present remotely following orbital fracture hardware...
Hematic pseudocysts are fibrous, nonepithelial lined capsules containing blood byproducts that typically present remotely following orbital fracture hardware implantation. Trauma, implant migration, and tissue erosion are believed to cause hemorrhage to pool within the capsular space. Risk factors include inadequate posterior fracture reduction and use of nonporous material which prevents fibrovascular ingrowth and stabilization. Mass effect from these lesions may cause patients to present with pain, lid swelling, hyperglobus, proptosis, lid retraction, motility restriction, or blurry vision. Pseudocysts associated with fracture hardware have been misdiagnosed as tumors or in one prior case as an infection. Herein we report a unique case of hematic pseudocyst masquerading as orbital cellulitis with maxillary sinusitis. A 59-year-old man presented with periorbital pain, hyperglobus, proptosis, and ptosis 2 years after repair of an orbital floor fracture. CT demonstrated a soft tissue collection adjacent to an implant as well as maxillary sinus opacification. He did not improve with antibiotics, at which point surgery revealed a pseudocyst and its contents were removed. This report describes a unique presentation of orbital pseudocyst and summarizes the literature on this entity.
PubMed: 35702518
DOI: 10.1159/000523890 -
Frontiers in Microbiology 2022Complicated rhinosinusitis is a rare but life-threatening pathology that requires both medical and surgical treatment as soon as possible. The spread of the infection...
INTRODUCTION
Complicated rhinosinusitis is a rare but life-threatening pathology that requires both medical and surgical treatment as soon as possible. The spread of the infection from the paranasal sinuses affects, most often, the orbit, patients presenting diplopia, preseptal cellulitis, orbital cellulitis, or even blindness alongside exteriorization of puss from the middle meatus and nasal obstruction.
MATERIALS AND METHODS
We carried out a retrospective review of 32 patients that were diagnosed in our clinic with complicated rhinosinusitis from 2015 to 2022. All the patients received at least one intravenous antibiotic, and some also received antifungal drugs. All patients underwent surgery, either endoscopically or combined approach. Nasal washout or nasal swabs during surgery were sent for laboratory examination in all patients, and we studied the microbial etiology in these extensive infections. A database with all the information regarding demographic and medical data was established.
RESULTS
78% of the patients were male, with a mean age of 50.55. A wide range of antibiotics were used, while some patients, diagnosed with mucormycosis also received antifungal drugs. The mean hospitalization period was 12 days. We correlated the type of antibiotic with the hospitalization period and the outcome but also the degree of involvement of the orbit and the microbial strains identified.
DISCUSSION
The management of patients with complicated rhinosinusitis is complex and dynamic and it must be tailored to every patient, after an interdisciplinary meeting with the infectious disease specialist, ophthalmologist, and rhinologist. The microbial strains that produce such important infections are sometimes multi-resistant or combined, patients usually already had followed a course of antibiotics at home, and choosing the right treatment is sometimes challenging.
PubMed: 36071977
DOI: 10.3389/fmicb.2022.960319 -
Journal of Ophthalmology 2020Adult orbital cellulitis (OC) occurs relatively rarely, and comprehensive studies that retrospectively evaluate OC are lacking. Here, we aimed to examine the clinical...
PURPOSE
Adult orbital cellulitis (OC) occurs relatively rarely, and comprehensive studies that retrospectively evaluate OC are lacking. Here, we aimed to examine the clinical characteristics and prognosis of OC in a tertiary general hospital.
METHODS
Between October 2010 and May 2019, patients presenting with clinical symptoms of OC in a tertiary general hospital were analyzed in this retrospective study. Twenty-six cases were identified for a detailed review. In these cases, 16 males and 10 females were diagnosed with orbital cellulitis by clinical characteristics and multimodal examinations. We divided patients into three groups: (1) patients secondary to rhinosinusitis, (2) patients secondary to endogenous infection(s) without endophthalmitis, and (3) patients secondary to endophthalmitis. For each group, age, gender, eye type, combined systemic diseases, clinical presentation, leukocyte count, blood culture, diagnostic imaging, therapeutic methods, length of stay, time of postoperation, and patient prognosis were analyzed in detail.
RESULTS
There were no significant differences regarding age, gender, preoperative leukocyte count, exophthalmia, blood culture, treatment, or visual changes within the three groups ( < 0.05). There were significant differences, however, in postoperative leukocyte count and ophthalmoplegia between the three groups ( < 0.05). The preoperative and postoperative logarithms of the minimum resolution angle scored by the best-corrected visual acuity (LogMAR BCVA) of group 3 were statistically significant compared to group 1 and group 2 ( < 0.05).
CONCLUSION
We confirmed that the prognosis of OC patients combined with systemic diseases was poor. Patients with OC secondary to endophthalmitis infrequently experience ophthalmoplegia; however, these patients still have poor visual outcomes. Patients cultured positive for infection may not be associated with liver abscess. The level of leukocytes may indicate the condition of the disease.
PubMed: 33520296
DOI: 10.1155/2020/8889341 -
The Ulster Medical Journal May 2016
Topics: Female; Hernias, Diaphragmatic, Congenital; Humans; Inappropriate Prescribing; Infant; Male; Orbital Cellulitis; Pediatrics; Practice Patterns, Physicians'; Symptom Assessment; Tomography, X-Ray Computed
PubMed: 27601769
DOI: No ID Found -
Singapore Medical Journal Jun 2020Limited data is available on paediatric orbital cellulitis in Asia. We aimed to describe demographic data, clinical presentation, predisposing factors, identified...
INTRODUCTION
Limited data is available on paediatric orbital cellulitis in Asia. We aimed to describe demographic data, clinical presentation, predisposing factors, identified microorganisms, choice of antibiotics and management in children with orbital cellulitis treated in a tertiary care centre in Malaysia.
METHODS
A retrospective review was performed on children with orbital cellulitis aged below 18 years who were admitted to Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2013 and December 2017.
RESULTS
A total of 14 paediatric patients fulfilling the diagnostic criteria for orbital cellulitis were included. Their mean age was 6.5 ± 1.2 years. Boys were more likely to have orbital cellulitis than girls (71.4% vs. 28.6%). Involvement of both eyes was observed in 14.3% of the patients. Sinusitis (28.6%) and upper respiratory tract infection (21.4%) were the most common predisposing causes. Staphylococcus aureus (28.6%) was the leading pathogen. Longer duration of hospitalisation was observed in those infected with methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei. 10 (71.4%) patients were treated with a combination of two or three antibiotics. In this series, 42.9% had surgical interventions.
CONCLUSION
Young boys were found to be more commonly affected by orbital cellulitis than young girls. Staphylococcus aureus was the most common isolated microorganism. Methicillin-resistant Staphylococcus aureus and Burkholderia pseudomallei caused severe infection. Sinusitis and upper respiratory tract infection were the most common predisposing factors. A majority of the children improved with medical treatment alone. Our findings are in slight disagreement with other published reports on paediatric orbital cellulitis, especially from the Asian region.
Topics: Adolescent; Child; Child, Preschool; Female; Hospitals, University; Humans; Infant; Malaysia; Male; Methicillin-Resistant Staphylococcus aureus; Orbital Cellulitis; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus
PubMed: 31598730
DOI: 10.11622/smedj.2019121 -
Ocular Oncology and Pathology Sep 2018We describe a case of choroidal melanoma initially presenting with orbital cellulitis, fulminant conjunctival swelling, and secondary angle closure. Despite treatment...
We describe a case of choroidal melanoma initially presenting with orbital cellulitis, fulminant conjunctival swelling, and secondary angle closure. Despite treatment with intravenous antibiotics, the patient's condition did not improve. With further investigations including ultrasound scan and magnetic resonance imaging, a high-density lesion was found within the globe. Characteristic imaging findings suggested a malignant origin and the lesion was found to be a melanoma on histopathological analysis.
PubMed: 30320095
DOI: 10.1159/000477546 -
Ocular Oncology and Pathology Dec 2020A masquerade syndrome is an atypical presentation of a neoplastic process that mimics an inflammatory condition. In this paper, we focus on orbital pseudocellulitis.
INTRODUCTION
A masquerade syndrome is an atypical presentation of a neoplastic process that mimics an inflammatory condition. In this paper, we focus on orbital pseudocellulitis.
CASE SERIES
Our case series includes 5 retinoblastoma patients with orbital pseudocellulitis at presentation. In 3 patients the disease was bilateral, in 1 trilateral, and in 1 unilateral. The eyes with pseudocellulitis were enucleated, while the fellow eyes were treated conservatively, when affected. Four patients responded well to the therapy and showed remission of the tumor. The patient with trilateral retinoblastoma did not respond to therapy and died of disease.
DISCUSSION
Differential diagnosis with infectious orbital cellulitis is extremely important. Patients with orbital cellulitis present with fever, sinusitis, leukocytosis, and raised inflammatory markers, while ophthalmoscopic examination is negative and imaging studies show sinus involvement. On the contrary, patients with retinoblastoma do not show systemic inflammation, while ophthalmoscopic examination reveals leukocoria, buphthalmos, and an intraocular tumor mass associated with retinal detachment. Magnetic resonance imaging shows intralesional calcifications and soft tissue edema without sinus involvement. Histology confirms the diagnosis.
CONCLUSIONS
Medical history, physical examination, and imaging studies are crucial in the diagnosis of retinoblastoma-associated orbital pseudocellulitis. Retinoblastoma should be excluded in all patients with signs of pre-septal orbital cellulitis through fundoscopy and/or imaging studies.
PubMed: 33447593
DOI: 10.1159/000509810 -
World Journal of Radiology Apr 2014Orbital inflammatory disease (OID) represents a collection of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential... (Review)
Review
Orbital inflammatory disease (OID) represents a collection of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagnosis including infection, systemic inflammatory conditions, and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cellulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously thought to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an important role in elucidating any underlying etiology behind orbital inflammation and is critical for ruling out other conditions prior to a definitive diagnosis of OID. In this review, we will explore the common sites of involvement by OID and discuss differential diagnosis by site and key imaging findings for each condition.
PubMed: 24778772
DOI: 10.4329/wjr.v6.i4.106