Intraconal Abscess Research Articles

809 An Unusual Presentation of Left Sided Orbital Pathology- Intraconal Abscess

Abstract Introduction Orbital cellulitis is a severe, life-threatening infection of the orbit and its contents posterior to the septum. Case Report A 41-year-old admitted to hospital under ENT with complete proptosis on left eye and raising intra ocular pressure (IOP) - 26mmHg. He initially presented to Ophthalmology with worsening left eyelid swelling, pain, reduced visual acuity (VA) from 6/18 to 6/12 for the past 4 weeks. This was associated with restricted EOM, proptosis of left eye but intact colour vision and left sided headaches refractory to topical management. His ENT exam including a flexible nasoendoscopy was normal. The CT Sinuses showed poorly enhancing retro orbital poorly enhancing mass. The differential diagnosis is wide and further assessment with MRI and tissue biopsy highly advised. He subsequently underwent MRI Head and Orbit with contrast: Appearances are suggestive of left periorbital cellulitis with an intraconal abscess. He was started on intravenous (IV) antibiotics. His IOP had now increase to 35mmHg for which he underwent emergency lateral canthotomy and cantholysis (LCC) in clinic. This successfully reduced the IOP to 21mmHg and he subsequently had formal drainage of the abscess. He made significant recovery and was discharged home a week after the operation. He went on to have repeat MRI- which showed almost complete resolution of the disease process. He was reviewed 4weeks postoperatively, his VA returned to 6/7.5 unaided 4 weeks but continued to have proptosis in that eye for which he is being followed up.

ORBITAL ABSCESS FOLLOWING A CLOSED FACIAL INJURY IN A YOUNG ADULT

Background: Orbital abscess formation is one of the uncommon complications that occur following facial trauma. . We report a rare presentation of orbital abscess in a young adult with post closed facial fracture. Materials and Methods: a case report Result: A 19-year old man who sustained head injury and facial bones fractures without any external adnexal wounds from a road traffic accident. He developed left periorbital haematoma and decrease vision after 3 days of trauma. He was suspected to have left optic neuropathy and empirically treated with corticosteroids. However, his left vision deteriorated and developed progressive proptosis within 3 days. Serial CT scan showed new formation of left subperiosteal and intraconal abscess. Endoscopic orbital decompression and drainage of the abscess was performed. Post operatively, his vision and the proptosis improved. Orbital abscess post closed facial fracture is an unusual complication. Conclusion: High index of suspicion is necessary to diagnose this unusual presentation. Prompt treatment is essential to save the vision. Keywords: Orbital abscess, optic neuropathy, facial trauma, orbital decompression

Elevated Optic Disc Height and Increased Optic Nerve Sheath Diameter on Bedside Ultrasound in a Pediatric Patient With Orbital Cellulitis: More Than Meets the Eye

BackgroundOrbital cellulitis is an uncommon ophthalmological emergency in children, but rapid emergency department (ED) diagnosis is essential. Case ReportA 13-year-old boy presented to our pediatric ED with left orbital cellulitis secondary to pansinusitis. Emergency bedside ocular ultrasonography was used to evaluate and expedite his management. Besides inflammatory changes observed on ultrasound of his affected orbit, the patient had an elevated optic disc height and increased nerve sheath diameter, which were not commonly reported in published literature on orbital cellulitis. Emergent computed tomography of the orbits and head showed orbital cellulitis without complications of orbital abscess or cavernous sinus thrombosis. Despite initiating early appropriate antibiotics, there was rapid progression of his disease and he developed intraconal abscess and cavernous sinus thrombosis the following day. After emergency surgical drainage of his pansinusitis, antibiotics, and anticoagulation, he was discharged well after a 2-week hospitalization. Why Should an Emergency Physician Be Aware of This?There are important advantages of using bedside ultrasonography for diagnosis of pediatric orbital cellulitis in the ED setting. Further research should be done to evaluate the clinical significance of an enlarged optic nerve sheath diameter and raised optic disc height in pediatric orbital cellulitis.

Orbital cellulitis and intraconal abscess formation after strabismus surgery in an adult patient

We report a 60-year-old woman who presented with orbital cellulitis, restricted ocular motility, proptosis, and visual acuity of counting fingers in her left eye 3 days after strabismus surgery. Although she initially responded well to antibiotic and anti-inflammatory therapy, visual acuity in the left eye again decreased on postoperative day 5. Radiographic imaging revealed an intraconal orbital abscess, and she underwent left lateral orbitotomy with abscess drainage, with continued antibiotics and a tapering dose of steroids. To our knowledge, this is the first case of orbital cellulitis and intraconal abscess after strabismus surgery in an adult.

Abscesso orbitário intraconal secundário a foco odontogênico: Relato de Caso

Abscesso orbitário intraconal secundário a foco odontogênico: Relato de Caso

Onodi Sinusitis Presenting with Orbital Apex Syndrome

This article reports the unusual presentation of a patient with an intraconal abscess secondary to sinusitis in an onodi cell in a healthy 63 year old Chinese female. She presented with limited extraocular movements, decreased corneal sensation, rapid drop in visual acuity and signs of optic neuropathy, in the absence of any inflammatory signs in the right eye. MRI scans showed a well-encapsulated mass in the posterior two thirds of the orbit, with the presence of an onodi cell on the right side. She underwent an extended lateral orbitotomy, which revealed frank pus that was positive for Staphylococcus aureus. She was treated with intravenous antibiotics with complete resolution of her presenting signs.

Acute Dacryocystitis Causing Orbital Cellulitis and Abscess

Purpose: Acute dacryocystitis commonly presents as preseptal cellulitis as lacrimal sac lies anterior to the orbital septum and hence infection localizes in the preseptal space. The purpose of this study is to describe presentation and management of cases of acute dacryocystitis presenting as orbital cellilitis and abscess secondary to acute dacryocystitis. Method: This retrospective, non-comparative, interventional case series included 6 patients presenting with orbital cellulitis and abscess secondary to acute dacryocystitis. All patients underwent drainage of abscess under general anesthesia. External dcaryocystorhinostomy was advised as the definitive treatment for all pateints. Result: Abscess was localized in the extraconal space in 4 patients and in the intraconal space in 2 patients. Patients with intraconal abscess had visual loss on presentation while vision could be preserved in patients with abscess in extraconal space. Both patients with intraconal abscess had history of acute dacryocystitis. Conclusion: Acute dacryocystitis is an ophthalmic emergency that can cause orbital cellulitis with abscess formation, and even vision loss, if left untreated.

Orbital abscess secondary to acute dacryocystitis: case report

Acute dacryocystitis usually induces preseptal infection. In rare instances the infection that is confined to the lacrimal sac can extend to the orbital contents resulting in orbital cellulitis. We present a case of intraconal abscess secondary to acute dacryocystitis and review the literature of orbital cellulitis resulting from acute lacrimal sac infection.

An Orbital Abscess Secondary to Acute Dacryocystitis

An orbital abscess is an ophthalmic surgical emergency that is typically caused by the spread of bacteria from adjacent structures, such as the sinuses, eyelids, or teeth. Although acute dacryocystitis is commonly associated with preseptal cellulitis, it rarely causes orbital infection. Infection of the lacrimal sac will typically localize in the preseptal space because the lacrimal sac lies anterior to the orbital septum. To the authors' knowledge, this is the first report of an intraconal abscess secondary to acute dacryocystitis. The key points in the surgical management of this entity are discussed.

Magnetic resonance imaging of orbital abscesses

The magnetic resonance imaging features of two orbital abscesses are reported, with correlation to clinical, computed tomographic and ultrasound findings.In the first case, a 16-year-old boy, after bilateral ethmoidal sinusitis, meningitis and right orbital cellulitis, developed an intraconal abscess. CT revealed a hypodense core, surrounded by a brighter pseudocapsule. On T1-weighted MRI, the center of the abscess appeared hypointense and the capsule isointense to muscle. On T2, the core was hyperintense, and the pseudocapsule was not evident. Ultrasonography showed a well-defined rounded lesion, with low-to-medium internal reflectivity. Follow-up was carried out by CT and ultrasound until complete healing.In the second case, after chemotherapy for a sytemic T-cell lymphoma, a 41-year-old man developed frontal and ethmoidal sinusitis and a left superior orbital mass originating from the frontal sinus. On T1-weighted MRI, the mass appeared hypointense, with a darker core, which appeared hyperintense on T2...

Dracunculiasis of the Orbit and Eyelid: Light and Electron Microscopic Observations of Two Cases

AbstractDracunculiasis, an infection caused by the nematode parasite, Dracunculus medinensis, usually affects the skin and subcutaneous tissue. The authors studied two cases of dracunculiasis involving the orbit and eyelid in African children. In the first case, the patient presented with proptosis and the clinical diagnosis was Burkitt's lymphoma. In the second patient, the eyelid lesion was diagnosed as a dermoid cyst. Histopathologically, the orbital lesion showed a degenerated and partially calcified worm within a large intraconal abscess. The eyelid lesion contained a well-preserved gravid female worm filled with larvae. The results of transmission and scanning electron microscopic studies are discussed.