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PubMed1985

Orbital cellulitis of dental origin: case report and review of the literature.

Orbital cellulitis is a rare condition, which usually develops as a complication of the infection of paranasal sinuses, namely ethmoidal, frontal and occasionally the maxillary sinuses. Maxillary sinusitis could result from dental infection. A case is presented illustrating how dental infection can proceed to maxillary sinusitis and orbital cellulitis. The clinical presentation and treatment are described. Possible complications are discussed.

Adolescent↗
PubMed1994

Orbital cellulitis--an unusual presentation and late complication of severe facial trauma.

We report an unusual case of orbital cellulitis in a patient with only one seeing eye and severe facial asymmetry secondary to a road traffic accident twenty two years previously. Facial trauma sustained in the road traffic accident created continuity between the right orbit and the adjacent ethmoidal cells. The abnormal communication between the ethmoidal labyrinth and the right orbit rendered this patient highly susceptible to an orbital cellulitis from an adjacent paranasal sinus infection. However, this case is unusual with regard to the length of time that elapsed before such an infection became manifest and the presence of gross distortion of anatomy masked the usual presentation and thereby caused a delay in diagnosis.

Accidents, Traffic↗
PubMed2006

Orbital cellulitis in a patient receiving infliximab for Ankylosing spondylitis.

PURPOSE: To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent. DESIGN: Single interventional case report. METHODS: A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus. RESULTS: Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks. CONCLUSIONS: Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.

Adult↗
PubMedDate not supplied

Subacute infratemporal fossa cellulitis with subsequent abscess formation in an immunocompromised patient.

OBJECTIVES: To present a case of subacute infratemporal fossa cellulitis with subsequent abscess formation to show important anatomic relationships as they effect presentation and treatment of infections in this area. STUDY DESIGN: Case report and brief literature review. METHODS: The case of an immunocompromised patient who developed subacute infratemporal fossa cellulitis with subsequent abscess formation is presented. A literature review discusses etiology, diagnosis, and treatment of these infections. RESULTS: Careful history and physical examination revealed unilateral facial pain, swelling, and trismus to be caused by an infratemporal fossa abscess. Intraoral drainage and intravenous antibiotic therapy led to resolution of the infection. CONCLUSION: Infratemporal fossa abscesses are potentially dangerous complications of odontogenic infections. Although clinical diagnosis may be difficult, knowledge of relevant anatomy and pathways of spread allow more effective diagnosis and treatment of these infections.

Abscess↗
PubMed2005

A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: comparative patient care audits.

In 2000 and 2002, the Royal Perth Hospital (RPH) Burn Unit, Western Australia, conducted two 'before and after' patient care audits comparing the effectiveness and cost of Silvazine (silver sulphadiazine and chlorhexidine digluconate cream) and Acticoat, a new dressing product for in-patient treatment of early burn wounds. The main outcome variables were: burn wound cellulitis, antibiotic use and cost of treatment. Two patient care audits and a comparative sample were used. The two regimes audited were, 'standard treatment' of twice daily showers or washes with 4% chlorhexidine soap and Silvazine cream as a topical dressing (2000, n=51), compared with the 'new treatment' of daily showers of the burn wound with 4% chlorhexidine soap and the application of an Acticoat dressing (2002, n=19). In 2002, costs were also examined using a sample of matched pairs (n=8) of current and previous patients. The main findings were: when using Acticoat the incidence of infection and antibiotic use fell from 55% (28/51) and 57% (29/51) in 2000 to 10.5% (2/19) and 5.2% (1/19) in 2002. The total costs (excluding antibiotics, staffing and surgery) for those treated with Silvazine were US$ 109,357 and those treated with Acticoat were US$ 78,907, demonstrating a saving of US$ 30,450 with the new treatment. The average length of stay (LOS) in hospital was 17.25 days for the Silvazine group and 12.5 days for the Acticoat group-a difference of 4.75 days. These audits demonstrate that Acticoat results in a reduced incidence of burn wound cellulitis, antibiotic use and overall cost compared to Silvazine in the treatment of early burn wounds.

Anti-Infective Agents, Local↗
PubMed2005

Orbital cellulitis after strabismus surgery.

Serious infection is uncommon after eye muscle surgery. Orbital cellulitis is a rarely reported but is potentially vision- and life-threatening complication after strabismus surgery. In this report, we describe a case of unilateral orbital cellulitis after strabismus surgery for sensory exotropia in a healthy adolescent boy.

Adolescent↗
PubMed2004

Orbital cellulitis after phacoemulsification and intraocular lens implantation.

We report a case of orbital cellulitis after uneventful phacoemulsification and intraocular lens implantation under peribulbar injection. The eyelid skin was prepared with chlorhexidine gluconate before the peribulbar injection, and the eyelid and conjunctival cul-de-sac were prepared with povidone-iodine before phacoemulsification. Five days postoperatively, the patient presented with reduced visual acuity and lid swelling. Ocular examination showed signs of orbital cellulitis, which was confirmed by a computed tomography scan. Oral erythromycin and metronidazole were given, after which the symptoms improved with successful outcomes.

Anti-Infective Agents↗
PubMed2004

Tubercular preseptal cellulitis in children: a presenting feature of underlying systemic tuberculosis.

OBJECTIVE: To present the clinical findings in 7 patients with preseptal cellulitis caused by tuberculosis. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Seven patients. METHODS: Review of clinical findings, course, diagnostic tools, and management of 7 cases with tubercular preseptal cellulitis. MAIN OUTCOME MEASURES: Healing of local and systemic lesions, cosmetic correction. RESULTS: The presenting features of tuberculosis included lid abscess formation in 5 cases, with spontaneous fistulization in 2 patients. Two cases were initially seen with a cicatricial ectropion of the upper lid. A history of a lid swelling with spontaneous fistulization was present in both cases. Nonresponsiveness of the lesions to systemic antibiotics led to a detailed evaluation of the patients, and evidence of an underlying active or healed systemic focus was present in all the cases. Acid-fast bacilli from pus from the discharging sinuses were identified in only 1 case, and in another patient, a biopsy specimen of the submandibular lymph node showed caseation necrosis. In the other cases, the diagnosis was presumptive from a strongly reactive Mantoux test, raised erythrocyte sedimentation rate, and the presence of a systemic focus. All the patients showed a dramatic response with antitubercular treatment, with complete healing of lesions. Two patients had a residual cicatricial ectropion, which was corrected surgically in both cases. CONCLUSIONS: Preseptal or lid involvement can be the presenting feature of tuberculosis and a marker for underlying systemic focus in children. Spontaneous fistulization of the abscess, minimal inflammatory signs, nonresponsiveness to antibiotic therapy, tethering to the underlying structures and skin, and the presence of a cicatricial ectropion should alert the clinician to look for an alternate diagnosis. The lid presentation might be a marker of an underlying systemic focus; therefore, awareness of the many faces of tuberculosis is important for ophthalmologists.

Antitubercular Agents↗
PubMed1988

Gangrenous cellulitis associated with gram-negative bacilli in pancytopenic patients: dilemma with respect to effective therapy.

INTRODUCTION: Gangrenous (necrotizing) cellulitis is a progressive bacterial infection of skin and soft tissue; the infection can spread into subcutaneous tissue with involvement of superficial and deep fascia (necrotizing fasciitis). We describe two pancytopenic patients with polymicrobial gram-negative bacteremia and fulminating gangrenous cellulitis. CASE REPORTS: Pseudomonas aeruginosa was isolated from a localized hemorrhagic area of the face in one patient. The chronology of infection in these two patients is documented in a series of dramatic color photographs. Despite appropriate antibiotic therapy, the infections progressed relentlessly and both patients died. COMMENTS: We discuss the dilemma of establishing the correct diagnosis prior to the appearance of the characteristic cutaneous manifestations of hemorrhagic necrosis and gangrene. Once the diagnosis is established, surgical excision is universally recommended. Unfortunately, bleeding diatheses in pancytopenic patients with co-existing coagulation deficiencies pose logistic obstacles in urgent, real-life situations. The timing and conditions for surgery need to be elucidated in these patients. An approach to this infection is proposed. The utility of frozen-section biopsy of the involved tissue and computed tomographic scans of the involved area remains to be evaluated.

Adult↗
PubMed2001

Orbital cellulitis caused by Fusobacterium necrophorum.

PURPOSE: To report the case of a previously healthy young female who developed orbital cellulitis caused by Fusobacterium necrophorum. We are unaware of previous reports of this condition caused by the same anaerobic, gram-negative, nonsporeforming bacterium and could find no reference to it in a computer search using MEDLINE. METHODS: Case report. RESULTS: In the case of orbital cellulitis presented here, the patient required 3 sinus debridement operations and 30 days of intravenous antibiotics. Despite this, her vision did not fully recover. CONCLUSION: F. necrophorum is capable of causing severe orbital disease that requires aggressive and prompt treatment to preserve sight.

Adolescent↗
PubMed2003

Langerhans cell histiocytosis with periorbital cellulitis.

PURPOSE: To report a case of Langerhans cell histiocytosis presenting as periorbital cellulitis. DESIGN: Interventional case report. METHODS: A 3-year-old girl presented with periorbital swelling of the right upper lid laterally of two days' duration. A history of recent eye trauma was reported. RESULTS: Computed tomography showed a soft tissue mass that eroded the frontozygomatic suture. The lesion was debulked through a lateral orbitotomy. Electron microscopy disclosed Birbeck granules. Immunohistochemistry stained positively for CD68 and CD1a antigenic determinants. CONCLUSIONS: Although rare, Langerhans cell histiocytosis can cause acute periorbital cellulitis in children. Trauma can induce an inflammatory response, allowing for earlier diagnosis of the orbital lesion.

Antigens, CD↗
PubMed1997

Streptococcal toxic shock syndrome complicating preseptal cellulitis.

PURPOSE: Although substantial morbidity is uncommon in preseptal cellulitis, the incidence of severe infection resulting from group A streptococcal infection is increasing. METHODS: A 62-year-old man was initially examined for preseptal cellulitis sustained after minor trauma to his brow. The patient rapidly experienced shock and multisystem organ failure. Intensive medical therapy prevented circulatory collapse and death. RESULTS: A diagnosis of streptococcal toxic shock syndrome secondary to group A beta hemolytic streptococcal infection was made based on culture results and clinical course. CONCLUSIONS: The ophthalmologist plays an essential role in diagnosing this condition. Aggressive and timely treatment are essential to preventing death.

Cellulitis↗
PubMed1996

Plasmacytoma manifesting as recurrent cellulitis and hematic cyst of the orbit.

PURPOSE: To describe a patient with recurrent periorbital cellulitis and orbital blood cyst as the initial manifestation of primary extramedullary plasmacytoma. METHODS: The chart, imaging studies, and histopathologic examination results and literature on the subject were reviewed. RESULTS: Orbital surgery disclosed a hematic cyst along with a solitary plasma cell tumor. CONCLUSIONS: Periorbital cellulitis and pain can be a manifestation of a plasma cell tumor. Bleeding may occur within a necrotic orbital tumor.

Aged↗
PubMed1991

Retinoblastoma manifesting as orbital cellulitis.

Five children with previously undiagnosed retinoblastoma had signs of unilateral orbital cellulitis and were treated with systemic antibiotics, corticosteroids, or both. When retinoblastoma was finally diagnosed clinically, radiologists believed in every case that, on the basis of the soft-tissue swelling seen with computed tomography, there was orbital extension of the tumor. However, intraoperative and histopathologic observations disclosed no demonstrable orbital tumor involvement. The affected eyes all had neovascular glaucoma, and all harbored highly necrotic tumors that were contained within the eye. We concluded that orbital inflammation can occur with retinoblastoma confined to the eye and that signs of orbital cellulitis do not necessarily imply orbital extension of the tumor.

Cellulitis↗
PubMed1999

Periocular abscess and cellulitis from Pasteurella multocida in a healthy child.

PURPOSE: To examine an unusual cause of periorbital cellulitis, Pasteurella multocida. METHODS: Case report, review of the literature. RESULTS: We treated a 13-year-old previously healthy child who developed Pasteurella preseptal cellulitis secondary to a cat bite and cat scratch. After receiving a dose of intravenous antibiotics and starting oral antibiotics, the child had delayed onset of several abscesses around the right eye, with marked pain and erythema. After incision and drainage, he improved. CONCLUSION: Pasteurella multocida is a rare but potentially serious cause of ocular infection. All cases of potential exposure should be treated promptly and followed until complete resolution of infection.

Abscess↗
PubMedDate not supplied

Two cases of malignant lymphoma complicated by hemophagocytosis resembling orbital cellulitis.

Two patients with malignant lymphoma complicated by hemophagocytic syndrome (HPS) are reported. Their clinical signs at onset were similar to those of orbital cellulitis. Lymphoma complicated by hemophagocytosis is called lymphoma-associated hemophagocytic syndrome (LAHS) and its prognosis is reported to be very poor. As far as we know, this is the first report in the ophthalmological field. In our patients, we suspected that the lesions occurred from the orbit or skin of this area. The first patient was a 22-year-old man and the second patient a 16-year-old girl. The diagnosis was very difficult at the onset of disease. They died within 6 months after the first ophthalmological examination. When orbital cellulitis is suspected and antibiotic therapy is ineffective, we should suspect HPS and should examine serum ferritin, which is a good marker of HPS. Early biopsy and consultation with a hematologist are very important.

Adolescent↗
PubMed1980

Hematoma of bowel and cellulitis of the abdominal wall complicating herniography.

Two complications of herniography are presented: a hematoma of bowel causing intestinal obstruction, and a cellulitis of the abdominal wall causing septicemia. A technical error probably caused the hematoma and gastroenteritis played a role in the cellulitis. We have now narrowed our indications for herniography. We think it should be reserved for more difficult diagnostic problems such as recurrent inguinal hernia, recurrent hydrocele or eventration of the diaphragm.

Abdominal Muscles↗