Affiliations 

  • 1 Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • 2 Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • 3 Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
  • 4 Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Electronic address: shatriah@usm.my
Int J Surg Case Rep, 2017;33:119-123.
PMID: 28314224 DOI: 10.1016/j.ijscr.2017.02.051

Abstract

INTRODUCTION: The management of orbital abscesses in neonates and infants is very challenging. Surgical drainage of the abscess is aimed at removing the pus and preventing blindness. We describe a case of orbital abscess in an infant that was caused by methicillin-resistant Staphylococcus aureus and that was successfully drained with image-guided endoscopic surgery.

PRESENTATION OF CASE: A 39-day-old infant presented with progressive right maxillary swelling complicated by methicillin-resistant Staphylococcus aureus orbital abscess. Tooth bud abscess was the most likely primary cause and a combination of intravenous antibiotics was initially prescribed. The collection of intra-orbital pus was removed using image-guided system-aided endoscopic surgical drainage.

DISCUSSION: Prompt diagnosis and management are very crucial. Endoscopic drainage of these abscesses in children has been described. Image-guided drainage of the orbital abscess is a newer technique that has been reported in a teenager and in adult patients. This is the first reported case of endoscopic orbital drainage surgery in an infant. The procedure was performed successfully. This approach provides for better identification of the anatomical structures in a very young patient. Injuries to the medial rectus, globe and optic nerve can be avoided with this technique.

CONCLUSION: Aggressive management of orbital abscesses in infants is mandatory. Image-guided endoscopic orbital drainage offers precise visualization and a safer technique in a relatively smaller orbit.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.