Abstract
BackgroundRhinosinusitis is a common condition which may present with complications commonly involving the orbit and the intracranial space. Loss of vision in the absence of clinical or radiological signs of involvement of the orbit and intracranium is rare and carries a high morbidity rate. Streptococcus equi subspecies zooepidemicus is not a well-documented cause of paranasal sinus infection.Case presentationWe present a case of a 16 year old female patient who had unilateral loss of vision with signs of retrobulbar optic neuritis and no other neurological signs. We isolated an unusual organism- Streptococcus equi subspecies zooepidemicus from the maxillary sinus. Emergency endoscopic sinus surgery and antibiotic treatment resulted in complete reversal of the loss of vision.ConclusionThe presence of paranasal sinus disease in association with loss of vision even in the absence of a clear link between the two should be treated as an emergency with surgical drainage and or appropriate antibiotic therapy. In patients presenting with suspected inflammatory orbital involvement, imaging of the orbit and paranasal sinuses should be considered early.
Highlights
Rhinosinusitis is a common condition which may present with complications commonly involving the orbit and the intracranial space
In patients presenting with suspected inflammatory orbital involvement, imaging of the orbit and paranasal sinuses should be considered early
Infections caused by Streptococcus equi subsp. zooepidemicus are uncommon with a variety of pyogenic clinical manifestations; skin and soft tissue infections, septic arthritis, endocarditis, meningitis, pneumonia, pharyngitis, lymphadenitis and osteomyelitis [13,14,15,16]
Summary
The presence of paranasal sinus disease in association with loss of vision even in the absence of a clear link between the two should be treated as an emergency with surgical drainage and or appropriate antibiotic therapy. In patients presenting with suspected inflammatory orbital involvement, imaging of the orbit and paranasal sinuses should be considered early
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