Complication Of Orbital Cellulitis Research Articles

Complications of orbital cellulitis in an infant with arteriovenous malformation


 
 
 Las infecciones oculares son frecuentes en la edad pediátrica, normalmente aparecen como complicación de la infecciones respiratorias altas o focos dentales, pero también pueden presentarse secundariamente a traumatismos o infecciones oculares.1 Se clasifican en celulitis preseptal y orbitaria dependiendo de la ubicación del compromiso de los tejidos, ya sea este delante o detrás del septum. La incidencia de la celulitis orbitaria es de 1.6/100 000 en la edad pediátrica, en comparación a 0.1/100 000 en adultos. Están descritas complicaciones sobre todo en las celulitis orbitarias, como infecciones intracraneales, abscesos orbitarios y alteraciones oftalmológicas2, como en el presente caso clínico de un lactante varón de 1 año y 3 meses de edad con celulitis orbitaria secundaria a lesión traumáticadepárpadoizquierdoconposteriores complicaciones neurológicas y pulmonares.
 
 

Pain management in a child with odontogenic orbital cellulitis and severe complications

Introduction. Orbital cellulitis is a diffuse purulent inflammation of the orbital tissues followed by necrosis. Complications of orbital cellulitis include meningitis or cerebral vascular thrombosis leading to death.Background. We present the case of a 3-year-old child with orbital cellulitis and severe complications treated at the Departmentof Anesthesiology and Intensive Care, CNE “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”.Results. The child presented to the ophthalmology department with complaints of pronounced lid edema and hyperemia, right eye exophthalmos, massive purulent, foul-smelling discharge from the right eye, hyphema of the inner and outer corners of the eye, absent movements of the right eyeball, hyperthermia. Non-contrast computed tomography of the brain revealed osteomyelitis of the right maxilla, cellulitis of the right orbit, right-sided sinusitis, ethmoiditis. Under general anesthesia, there were performed deep orbitotomy, extraction of teeth 54, 55 with the extraction area drainage, puncture of the right maxillary sinus. Multimodal analgesia, detoxification therapy, empiric antimicrobial therapy, immune replacement therapy, protein replacement therapy, and syndromic treatment were chosen. On the 9th day, the child’s condition improved, and he was transferred to the ophthalmology department. On the 27th day of hospital stay, the child was discharged home in a satisfactory condition.Conclusions. The child’s recovery was achieved due to timely hospitalization and surgery, goal-directed antibiotic therapy, application of multimodal anesthesia principles and adequate pain management, immune replacement therapy, usage of non-specific detoxification methods and adequate rehydration therapy.

Isolated cortical vein thrombosis complicating orbital cellulitis

Background: Orbital cellulitis is characterized by the infective inflammation of orbital structures, usually posterior to the orbital septum. Extension of infection from the paranasal sinuses is the most common etiology for orbital cellulitis. Intracranial complications of orbital cellulitis include meningitis, subdural empyema, brain abscess, and cavernous sinus thrombosis.
 Case presentation: A 33-year-old man presented with acute onset of foul-smelling mucopurulent nasal discharge and swelling of the left eye followed by altered sensorium. On examination of the left eye, chemosis, eyelid edema, and proptosis were present. Computed tomography (CT) of the brain revealed non-axial left proptosis with inflammatory reticulation in the intra- and extraconal fat alongside sinusitis. Magnetic resonance imaging of the brain confirmed the CT findings and additionally showed meningitis and subdural empyema along the left frontoparietal convexity with parenchymal signal changes, suggesting venous infarction in the left frontal lobe. Susceptibility weighted imaging (SWI) confirmed thrombus in the frontal polar vein on the left side, suggesting septic isolated septic cortical venous thrombosis (ICVT) as a complication of orbital cellulitis. Cerebrospinal fluid showed polymorphonuclear cell pleocytosis with elevated protein and lowered sugar. Blood and conjunctival swab cultures were negative. He was subsequently treated with intravenous broad-spectrum antibiotics and antifungals to which he responded and was discharged in stable condition.
 Conclusions: Our case highlights the presentation of septic ICVT complicating orbital cellulitis and paranasal sinusitis. It also underscores the higher sensitivity of SWI as a crucial tool in diagnosing ICVT. Appropriate and prompt medical treatment in orbital cellulitis can prevent further complications.

A rare complication of orbital cellulitis in a diabetic case: Cavernous sinus thrombosis

A rare complication of orbital cellulitis in a diabetic case: Cavernous sinus thrombosis

Adjunctive Use of Hyaluronic Acid Gel (Restylane Sub-Q) in Anophthalmic Volume Deficient Sockets and Phthisical Eyes

This study aims to present the use of Restylane Sub-Q for orbital volume augmentation in patients with secondary volume deficiency either postenucleation or postevisceration or those with phthisical eyes. This prospective case series reviews clinical, photographic, and radiologic records of 16 patients with anophthalmic or enophthalmic orbits who underwent volume augmentation by injection with hyaluronic acid gel in the intraconal and extraconal posterior orbit. The technique is discussed in detail. The volume of hyaluronic acid gel injected ranged from 2 to 4 ml (mean volume, 2.3 ml) per orbit, with a mean reduction of enophthalmos of 3.7 mm (71.4%) at 1 week, 2.8 mm (59.9%) at 6 months, and 2.5 (51.3%) at 12 months, with follow-up of 94.1%, 68.8%, and 50% of the patient group, respectively. Follow-up after 12 months consisted of subjective feedback from the patient. With the exception of one patient, the mean subjective follow-up period was 14.7 months (maximum, 22.4 months; minimum, 1.6 months). The procedure was well tolerated by 15 of the 16 patients who all experienced an improvement in cosmetic appearance. There was one possible complication of orbital cellulitis (although not examined by our clinic); this patient did not attend further follow-ups. One patient had full correction of her enophthalmos, which was maintained over 12 months. Hyaluronic acid gel injections in patients with enophthalmic sockets appear to be a safe, tolerable, and minimally invasive alternative for orbital volume augmentation in the outpatient setting. However, as predicted, its affects are temporary, and volume does begin to decrease within 12 months of injection.

Orbital cellulitis complicating sinusitis: a 15-year review

Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess.Method: A fifteen-year retrospective review (1986 – 2000) of all cases of orbital cellulitis, but with special focus on those of sinogenic origin seen at the University College Hospital, Ibadan, Nigeria.Results: Ninety patients were managed. There was a male preponderance (M: F ratio of 2:1) while 84% of the patients were below 20 years of age. Sinogenic orbital cellulitis constituted 57% of the study population (ninety cases) with the left orbit being involved most (55%), while the maxillary sinus had the highest incidence of sinusitis either singly (18%) or combined (65%). Complication of orbital cellulitis was found to be 52%, with no death but 11% became blind due to panophthalmitis.Conclusion: Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. It is hoped that a well-structured health education/awareness programme and early referral to specialists will improve the final outcome.

MRI of Orbital Cellulitis and Orbital Abscess: The Role of Diffusion-Weighted Imaging

Our aims were to describe the role of diffusion-weighted imaging (DWI) in detecting abscess as a complication of orbital cellulitis and to assess whether abscess can be diagnosed with a combination of conventional unenhanced sequences and whole-brain DWI with parallel acquisition. Nine cases of orbital cellulitis imaged with MRI were retrospectively reviewed, including six cases with pyogenic abscess. In this preliminary study, DWI improved diagnostic confidence in nearly all cases of orbital abscess when used in conjunction with contrast-enhanced imaging. DWI also confirmed abscess in a majority of cases without contrast-enhanced imaging, which may be of particular use when contrast material is contraindicated.

Orbital cellulitis.

Forty-nine cases of orbital cellulitis were reviewed. The average age of patients at presentation was 31 years. The onset of symptoms varied from seven days or less in 28 patients, one to four weeks in 17 patients, and more than four weeks in four patients. The leucocyte count, available in 33 patients, was greater than 10 X 10(9)/l in only nine. Abnormal sinuses were noted radiographically in 61%. Computed tomography scans, performed on nine patients, revealed non-localised inflammation in three and an orbital mass in six. Cultures, in general, were disappointing. Seventeen surgical procedures were performed on 14 patients. The complications of orbital cellulitis, occurring in five patients, included osteomyelitis of the maxillary bone, strabismus, afferent pupillary defect, chronic draining sinus, and scarred upper eyelid. Usually the treatment of orbital cellulitis requires aggressive parenteral antibiotic therapy and judicious surgical intervention.

Acute infarction of the choroid and retina. A complication of orbital cellulitis.

Acute infarction of the choroid and retina. A complication of orbital cellulitis.