Intraorbital wooden foreign body — a case report

Abstract

Background: Wood as an intraorbital foreign body (IOFB) is infrequent, and as it is organic matter patients represent an increased risk of infection. The aim of this study is to report the complexity of treatment of patient with a wooden IOFB. We describe a case of a 67-year-old male with a wooden IOFB. Case report: On referral, the patient presented with exophthalmos, pain, blurry vision and discharge from his left eye was admitted to the Department of Ophthalmology, Medical University of Gdansk. The previous evening, he fell with his face down. Computed tomography revealed a low-density IOFB of approximately -980 Hounsfield Units, sized 62 × 8 mm, in the area of left orbit, ethmoid and sphenoid sinus. Subsequently, the IOFB was removed under general anaesthesia. After three days of empirical antibiotic therapy, the patient was discharged with a switch to oral antibiotics. Shortly after the conversion to oral therapy, he developed an orbital inflammatory syndrome and was readmitted to the hospital. His condition improved after readministration of parenteral antibiotics. Conclusion: This case demonstrates that wooden IOFBs should be treated with caution. Parenteral antibiotic delivery leads to higher serum levels than with oral intake, and in this case, was essential in preventing infection after IOFB removal.