Cellulitis and erysipelas.
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The authors report three cases. Hemostasis abnormalities and lowering of complement fractions was observed. Severe shock was lethal in two cases associated with severe local lesions. The role of unadapted treatment like corticosteroids and the lack of early penicillino therapy is discussed to explain this evolution.
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We report a patient who rapidly developed unilateral proptosis and complete ophthalmoplegia following blunt trauma to the orbit. Computed tomography (CT) scan revealed a mass involving the sinuses and orbit with erosion of the cribriform plate. Biopsy of this suspected neoplasm revealed features consistent with allergic Aspergillus sinusitis, but cultures later grew a Bipolaris species. Our review of the literature suggests that when allergic fungal sinusitis involves the orbit, Bipolaris is a more commonly isolated organism than Aspergillus. Additionally, extraocular motility impairment and proptosis occur more frequently than visual loss. Treatment is controversial, but surgical drainage followed by corticosteroids is the most often recommended therapy.
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