Bilateral intraorbital abscesses with intracranial complications in a young Cameroonian girl: a case report

Abstract

Background:Intraorbital abscess is a very severe infection with ophthalmologic and neurologic complications that are sometimes life-threatening.Objective:To report the etiologic, clinical, radiologic, and prognostic features of one case of bilateral intraorbital abscesses with intracranial complications.Case report:A 15-year-old Cameroonian girl in a comatose state (11/15 on the Glasgow Coma Scale) with meningeal signs, right hemiplegia, right facial palsy, and bilateral exophthalmia was admitted for meningitis and cerebral abscess secondary to orbital cellulitis. A lumbar tap was carried out, no organisms were seen by Gram stain, and culture was negative due to previous antibiotic therapy. A computed tomography scan showed a left internal capsule infarct and a pansinus opacification. Bilateral superior orbitotomies were performed and the abscess evacuated. Microscopy and culture of surgical material were negative. The patient was discharged 4 weeks after hospital admission with a visual acuity of 0.1 in both eyes, aphasia, and right hemiplegia. Nine months later, there was complete visual recovery (visual acuity 1.0 in both eyes). Anterior and posterior segments were normal on slit-lamp examination. There was no aphasia, but right-sided hemiparesis persisted.Conclusion:The authors emphasize the need for prevention, early diagnosis, and adequate treatment of orbital cellulitis in order to avoid complications.

Delayed intraorbital infection after craniofacial bone surgery

“…Intraorbital infection, which has various etiology and sometimes leaves serious sequelae, has been reported through several articles [1,[3][4][5][6][7][8]. Commonly mentioned in these reports, early diagnosis and active treatment were most important.…”

“…Commonly mentioned in these reports, early diagnosis and active treatment were most important. The diagnosis of orbital infection was made clinically, and imaging helped for confirmation or delineating the source and extension of the infection [1]. Imaging findings were usually correlated to Chandler's clinical classification if the Chandler score was III or higher indicated "significant orbital infection" and needed active treatment [9].…”

“…Imaging findings were usually correlated to Chandler's clinical classification if the Chandler score was III or higher indicated "significant orbital infection" and needed active treatment [9]. Though incidence rates are low, this type of infection can result in critical situations such as blindness, death or extended infection to the brain [1]. Early-stage infection can be detected by identifying signs of soft tissue swelling, redness and increased warmth of the eyelids.…”

“…Sometimes, it could be diffuse with a collection of pus in the orbital cavity. This type of intraorbital infection showed relatively low incidence, but it might extend to the brain, cause blindness or even death [1]. Its most common source is paranasal sinusitis.…”

Simultaneous Orbital and Intracranial Abscesses in 17 Cases

“…8,9 The demographics, treatment, and outcomes of patients with severe orbital cellulitis and its subsequent intracranial complications are limited to case reports and small case series. [10][11][12][13][14][15] Management of these patients differ significantly from case to case.…”