MyMedR

Displaying publications 21 - 40 of 41 in total

Abstract:

Sort:

"Fleshy" Skin Cellulitis: A Triggering Factor for ANCA Associated Vasculitis

Yang SC, Mustafar R, Kamaruzaman L, Wei Yen K, Mohd R, Cader R

Acta Med Indones, 2019 Oct;51(4):338-343.
PMID: 32041918

A 59-year-old lady with underlying hypothyroidism presented with acute contact dermatitis progressed to cellulitis with superimposed bacterial infection and acute kidney injury. She responded to initial management with antibiotics, but a week later, she had cutaneous and systemic vasculitis. Her skin biopsy consistent with immune-mediated leuko-cytoclastic vasculitis and her blood test was positive for cytoplasmic-anti-neutrophil cytoplasmic antibody (c-ANCA). A diagnosis of ANCA-associated vasculitis was made and she was treated with immunosuppressant with plasmapheresis and hemodialysis support for her kidney failure. Despite aggressive measures, the patient succumbed to her illness. This case report demonstrates that soft tissue infection could trigger the development of ANCA-associated vasculitis whilst a background of hypothyroidism serves as a predisposing factor as both condition were reported separately in a couple of case studies before.

Matched MeSH terms: Cellulitis/diagnosis*; Cellulitis/pathology
Fulltext A rare case of heterotopic ossification in a newborn: a case report

Khoo S, Felix L, Azura L, Manmohan S, Jeffry A

Malays Orthop J, 2012 Nov;6(3):48-50.
PMID: 25279058 MyJurnal DOI: 10.5704/MOJ.1207.006

Heterotopic ossification (HO) is the growth of bone in soft tissue, and can be broadly classified into neurogenic, genetic and traumatic causes. The pathophysiology of HO remains unknown. This disorder is extremely rare in infants and can mimic or coexist with thrombophlebitis, cellulitis or osteomyelitis. Most importantly, HO has to be differentiated from bone-forming tumours such as osteosarcoma and osteochondroma. We report a case of traumatic HO in a fiveday- old newborn following intravenous cannulation of the right wrist and left ankle, with the latter complicated with osteomyelitis. We highlight the clinical and radiological features of HO and differential diagnoses of soft tissue ossification in early childhood.

Matched MeSH terms: Cellulitis
Fulltext Acute ptosis as a presentation of preseptal cellulitis leading to cerebral abscess in a patient with uncontrolled diabetes

Razali NR, Choo YM

Malays Fam Physician, 2021 Mar 25;16(1):136-138.
PMID: 33948155 DOI: 10.51866/cr1010

Acute ptosis due to preseptal cellulitis requires urgent medical attention, as the infection can extend posteriorly into the orbit, leading to significant visual and cerebral complications. We report a case of a 58-year-old woman with uncontrolled diabetes mellitus presenting with acute ptosis due to preseptal cellulitis. After initial resolution of fever with intravenous amoxicillin-clavulanate, she experienced a seizure due to cerebral abscess a week later and was treated with intravenous ceftriaxone. Preseptal cellulitis is usually treated on an outpatient basis with oral antibiotics, as it rarely extends posteriorly to cause cerebral complications. We wish to highlight the importance of admitting patients with preseptal cellulitis in patients with uncontrolled diabetes for intravenous antibiotics due to the potential for visual and cerebral complications.

Matched MeSH terms: Cellulitis
Fulltext What eyes behold if missed can be a life taking event: a case of orbital cellulitis

Reza, M.Q., Johar, M.J., Ismail, M.S.

Medicine & Health, 2013;8(2):89-93.
MyJurnal

Orbital cellulits is one of the life threatening event that should not be missed out and must be distinguished from preseptal cellulitis. It is an infective process involving ocular adnexal structures posterior to the orbital septum. High index of suspicion is the key to its diagnosis as even experienced physician can miss. Here, we present a case of a 15-year-old female who presented with progressive swelling over right forehead associated with high grade fever, headache and purulent discharge of the swelling. She was diagnosed with sepsis due to right forehead abscess and was treated with intravenous antibiotics followed with admission. However, she suddenly deteriorated in the ward which required intubation and thereby Intensive Care Unit (ICU) admission. Investigations revealed fluid collection at right retrobulbar space suggestive of an abscess where emergency drainage was carried out. Unfortunately, her condition worsened and patient succumbed at day-10 of admission, despite all efforts.

Matched MeSH terms: Cellulitis
Fulltext Case report: progression of pre-septal cellulitis to orbital subperiosteal abscess despite intravenous broad-spectrum antibiotics in a child

Noor Aniah A, Norshamsiah MD, Safinaz MK, Bastion, MLC, Mawaddah A

Journal of Surgical Academia, 2016;6(1):62-65.
MyJurnal

We report a case of a 7-year-old girl who initially presented with painless right eyelid swelling with full extra-ocular movement (EOM). She was treated with intravenous broad-spectrum antibiotics for preseptal cellulitis but her condition worsened. An urgent magnetic resonance imaging (MRI) of the brain and orbit showed orbital abscess, subperiosteal abscess in the medial orbital wall and evidence of sinusitis in the anterior ethmoidal air cells. She underwent Endoscopic Orbital Decompression (EOD) surgery on day 4 of presentation and her condition improved remarkably. We report a case of orbital abscess with subperiosteal abscess in the medial orbital wall. This case highlights the possibility of progression of orbital cellulitis despite administration of a broad-spectrum antibiotic.

Matched MeSH terms: Orbital Cellulitis
Fulltext Awake fibre optic intubation with Dexmedetomidine for Ludwig Angina with severe Trismus

Mohd Zulfakar Mazlan, Nik Abdullah Nik Mohammad, Mohamad Hasyizan Hasan, Irfan Mohamad, Zeti Norfidiyati Salmuna, Roselinda Ab Rahman

Malaysian Journal of Medicine and Health Sciences, 2018;14(2):89-92.
MyJurnal

Ludwig angina is a submandibular space cellulitis secondary to oral cavity infection. It is strongly associated with difficult intubation due to limitation in the mouth opening. The presentation of Ludwig angina varies according to the severity of the infection. The extreme presentations include upper airway obstruction and respiratory failure. We present a female teenager with right submandibular abscess as the consequence of Ludwig angina, who was planned for incision and drainage. Successful awake fibre optic intubation was performed as a method of induction due to trismus, deferring the need for tracheostomy.

Matched MeSH terms: Cellulitis
Fulltext Varicella zoster causing preseptal cellulitis - uncommon but possible

Qualickuz Zanan NH, Zahedi FD, Husain S

Malays Fam Physician, 2017;12(3):37-39.
PMID: 29527280

Background: Varicella has been known to be a harmless childhood disease. However, it has been reported that severe complications have taken place following Varicella infection, in both immunocompetent, as well as immunocompromised, individuals. Cutaneous complications of Varicella may manifest as preseptal cellulitis, albeit rarely.

Report: We present a case of a 4-year-old boy who presented with symptoms and signs of preseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngology team for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presenting with a swollen red eye may be a case of true orbital cellulitis. He was treated successfully with intravenous antibiotics and surgical drainage of the preseptal collection.

Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may lead to cutaneous complications in the pediatric age group, especially in children who are 4 years and younger. They may develop preseptal cellulitis, whose presentation might mimic that of orbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. A nasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a cause of orbital cellulitis.

Matched MeSH terms: Orbital Cellulitis
Nasal NK/T-cell Lymphoma Presenting as Acute Inflammation of Nasal Vestibule

Vasiwala R, Mohamad I, Venkateswaran SP, Hamzah SZ

Indian J Otolaryngol Head Neck Surg, 2019 Nov;71(Suppl 3):1986-1989.
PMID: 31763280 DOI: 10.1007/s12070-018-1402-8

Extra nodal nasal NK/T cell lymphoma is relatively a rare type of non-Hodgkin lymphoma. Variable clinical presentation with rapidly progressive necrosis of the cartilaginous and bony wall of the nose and upper respiratory passages leads to delayed diagnosis and treatment. A 43-years-old patient presented with right nasal pain and furuncle-like swelling. The swelling progressed rapidly to cellulitis to the face up to the right eye. Within 2 months, it had advanced to necrosis of the lateral vestibular cartilage, medial maxillary wall, turbinate and nasal septal cartilage. Biopsy reported as non-Hodgkin diffuse T cell (angiocentric T cell) lymphoma.

Matched MeSH terms: Cellulitis
Fulltext Dental infection presenting with ipsilateral parapharyngeal abscess and contralateral orbital cellulitis - a case report

Embong Z, Ismail S, Thanaraj A, Hussein A

Malays J Med Sci, 2007 Jul;14(2):62-6.
PMID: 22993494 MyJurnal

A 43 year-old man presented with pain on the right tooth for three days duration. Computed tomography showed left orbital cellulitis and right parapharyngeal abscess. There was also evidence suggestive of a dental abscess over right upper alveolar region. Magnetic resonance imaging revealed left superior ophthalmic vein thrombosis. Emergency drainage of the right parapharyngeal abscess was performed. Right maxillary molar extraction revealed periapical abscess. Left eye proptosis markedly reduced after initiating heparin.

Matched MeSH terms: Orbital Cellulitis
Late presentation of retinoblastoma in Malaysia

Menon BS, Alagaratnam J, Juraida E, Mohamed M, Ibrahim H, Naing NN

Pediatr Blood Cancer, 2009 Feb;52(2):215-7.
PMID: 18855905 DOI: 10.1002/pbc.21791

The aims of this study were to review the presenting features, treatment and outcome for Malaysian children with retinoblastoma currently.

Matched MeSH terms: Orbital Cellulitis/etiology
Cutaneous melioidosis and necrotizing fasciitis with pulmonary involvement in a chicken seller

Ariza A

Southeast Asian J Trop Med Public Health, 2008 Jul;39(4):656-8.
PMID: 19058602

Melioidosis is endemic in Malaysia. Cutaneous melioidosis is one manifestation and it may progress to necrotizing fasciitis. The case highlights a 46-year-old male, a chicken-seller who presented with scalp cellulitis which later progressed to necrotizing fasciitis and pneumonia are presented here. It illustrates several key features of the presentation, prompt laboratory diagnosis and early treatment of melioidosis which saved the patient's life.

Matched MeSH terms: Cellulitis/microbiology
Fulltext Melioidosis transfusion transmitted infection in beta thalassemia patient’s

Sahrol Nizam Bin Abu Bakar, Al-Afiq Alias, Masrah Tata

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):100-100.
MyJurnal

Introduction:Transfusion Transmitted Infections is occurring worldwide. The common organisms related reported in literature were Human Immunodefiency Virus, Hepatitis B and C Virus, bacterial contamination and Malaria par-asites. Meanwhile, Melioidosis is endemic disease in Malaysia and especially Sabah. Mortality due to Melioidosis septicaemia was also high. It ranges between 60%-80%. In Sabah, 74% of Thalassemia children were diagnosed with Bacteraemia Melioidosis and 50% had died due to the organisms. The incidence of Melioidosis Transfusion Transmitted Infection is rarely reported in the literature. Case Description: A 17-year-old girl was diagnosed having Beta thalassemia major since 5 years old and splenectomised 8 years ago. Currently on prophylaxis Penicillin and Ex-jade. She was admitted into hospital for monthly blood transfusion. Two days prior to admission, patient complained of having sore throat and cough but no fever and other complained. On examination, the tonsil enlarged and was treated as exudative tonsillitis. She was transfused with 2 pint packed cells within 2 days. No transfusion reaction noted. Day seven admission, she had high grade fever and redness of the right hand cannulation site and was treated as right hand cellulitis with intravenous Cloxacillin. Full blood count shows Total White Cell count was 24.9 x109 /L, Haemoglobin level was 9.3 g/dl and Platelets was 462x109/L. Blood for culture and sensitivity was taken and Chest X-ray noted haziness over the left mid and lower zone of the lung and was treated as Hospital Acquired Pneumonia. She was referred to tertiary hospital for further management. Her conditioned deteriorated and died at the casualty unit in the tertiary hospital. Blood culture was positive for Burkholderia pseudomallei. The case was reported to Dis-trict health office for further investigation. Blood donor tracing was done and was positive for Melioidosis through Elisa Antibody titre IgM for Melioidosis (1:320). The patient’s house and school were visited and investigated. All environmental samples were negative for Burkholderia pseudomallei. Conclusion: Its shows a relationship between blood donations infected with Burkholderia pseudomallei causing mortality of Beta Thalassemia patients. It is highly recommended to screen all blood products for communicable disease fatal organisms.

Matched MeSH terms: Cellulitis
Fulltext Combined Techniques of Non-invasive 99mTc-Besilesomab/99mTc-Sulfur Colloid with Hybrid SPECT/CT Imaging in Characterising Cellulitis from Symptomatic Perimegaprosthetic Infection: A Case Report

Tagiling N, Mohd-Rohani MF, Wan-Sohaimi WF, Faisham WI, Nawi NM

Malays Orthop J, 2020 Nov;14(3):188-193.
PMID: 33403085 DOI: 10.5704/MOJ.2011.032

Megaprosthesis is used to restore the form and function of massive skeletal defects, but it is accompanied by risks of failure, mainly due to perimegaprosthetic infection (PMI). In practice, the diagnosis of infected megaprosthesis among patients with a high index of clinical suspicion, elevated serological markers, and multiple negative or inconclusive imaging can be very challenging and poses a diagnostic conundrum to many orthopaedic surgeons. We present the case of a symptomatic 26-year-old female with large B-cell lymphoma who developed cellulitis with suspected complication of PMI 15 months post-implantation. The combination of advanced nuclear medicine imaging strategies, i.e., 99mTc-besilesomab/99mTc-sulfur colloid scintigraphy with hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) scanning helps to characterise and delineate both infections. Invasive procedures such as joint aspiration and biopsy were avoided, and the patient was successfully treated with antibiotics. Hence, we report a case where advanced imaging modalities were decisive in the investigation of PMI.

Matched MeSH terms: Cellulitis
Fulltext Orbital Cellulitis Secondary to Dental Abscess in Children

Abdul Satar H, Yaakub A, Md Shukri N, Ahmad Tajudin LS

Cureus, 2021 Apr 09;13(4):e14392.
PMID: 33981511 DOI: 10.7759/cureus.14392

Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications, including blindness, cavernous sinus thrombosis, cerebral venous sinus thrombosis, meningitis, subdural empyema, and brain abscess. Of the patients with orbital cellulitis, 17% died from meningitis, and 20% of the survivors had permanent loss of vision. Therefore, the potential for sight- and life-threatening complications makes prompt diagnosis and early treatment very important. We report here a case of a two-year-old girl who presented with a three-day history of left periorbital swelling, preceded by left upper perioral swelling that extended upward to the left cheek and left lower lid and was associated with low-grade fever. The patient had been admitted and was treated as having left preseptal with facial cellulitis; the patient was started on intravenous amoxicillin/clavulanic acid (200 mg three times per day dose), and chloramphenicol ointment was applied to the periorbital area. On day 3, the condition worsened, and dental examination showed multiple dental caries, upper gum swelling and abscess, and mobility of teeth 61 and 62 (two baby teeth). Contrast-enhanced computed tomography (CECT) of the orbit, paranasal, and brain showed a left periosteal abscess collection extending to the inferomedial region of the orbit. Examination and tooth extraction were performed under general anesthesia. The intraoperative results showed the presence of a left upper gum abscess, which was possibly the primary source of infection. Clinical improvement was observed postoperatively. Orbital cellulitis can be a complication of a dental abscess. This case emphasizes the importance of primary tooth care in children. A lack of care can result in fatal complications.

Matched MeSH terms: Orbital Cellulitis
Fulltext A rare complication of MRSA lid abscess and orbital abscess following strabismus surgery in a child

Kenneth Teow, K. L., Nor Akmal, B., Jamalia, R., Safinaz, M. K.

Journal of Surgical Academia, 2018;8(1):32-35.
MyJurnal

Strabismus is one of the most common ocular problems affecting the preschool population and the aim of strabismus surgery is to correct abnormal alignment of the eyes. A 5-year-old girl with strabismus underwent an uneventful surgery and was discharged on the same day with topical medications. Two days later, she returned with a painful right lower eyelid swelling, eye discharge and fever which started 1 day post-surgery. She was admitted for intravenous (IV) antibiotic. Symptoms initially improved after 24 hours of treatment, but later she had worsening eyelid swelling. An urgent CT scan of the orbit showed a right lower lid abscess with orbital cellulitis. Subsequently an examination under anaesthesia (EUA) and incision and drainage (I&D) of the lower lid abscess were performed. Culture from the pus grew Community Acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA), sensitive to Vancomycin. At day 2 post I&D she subsequently developed another episode of localised right lower lid swelling. Another EUA was done but showed the lower lid and wound was free of pus. She was later found to have a toxic reaction to topical Gentamicin and hence this medication was stopped. She responded well to treatment and was discharged after completing her IV antibiotics. At 14 months outpatient follow up, she was well and orthophoric in primary gaze. While treating a disease, we should be opened to all possibilities and not to treat with multiple antibiotics once susceptibility is known

Matched MeSH terms: Orbital Cellulitis
Ocular tuberculosis in Hospital Universiti Sains Malaysia - A case series

Shahidatul-Adha M, Zunaina E, Liza-Sharmini AT, Wan-Hazabbah WH, Shatriah I, Mohtar I, et al.

Ann Med Surg (Lond), 2017 Dec;24:25-30.
PMID: 29062482 DOI: 10.1016/j.amsu.2017.10.003

INTRODUCTION: Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by Mycobacterium tuberculosis, a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated.
PURPOSE: To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM).
METHOD: A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016.
RESULTS: The mean age was 43 ± 14.6 years old. Both male and female affected in about 1:1 ratio. The majority of subjects were local Malays (91.2%). Risk factors included previous contact with pulmonary TB patients (38.2%), and patients with underlying diabetes mellitus (26.5%). Most patients showed normal chest radiography (79.4%). However they had positive Mantoux test (94.1%) and raised erythrocyte sedimentation rate (ESR) value (58.8%). Uveitis was the most common ocular manifestation of ocular TB (70.6%) while the rare ocular manifestations included optic perineuritis and optic neuritis, orbital apex syndrome, orbital cellulitis, sclerokeratitis, corneal ulcer and conjunctival abscess. All patients responded well to anti-TB treatment, but visual outcome was variable.
CONCLUSIONS: This review shows the diverse entity of ocular TB spectrum in an endemic area. Good clinical response to anti-tuberculous therapy supported the presumed diagnosis of ocular TB in majority of the cases.

Matched MeSH terms: Orbital Cellulitis
Fulltext Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

Zuhaimy H, Aziz HA, Vasudevan S, Hui Hui S

GMS Ophthalmol Cases, 2017;7:Doc04.
PMID: 28194321 DOI: 10.3205/oc000055

Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect. The fundus was normal. The extraocular movements were restricted in all directions of gaze. Nasal endoscopy revealed pansinusitis that corresponded with CT scan orbit and paranasal sinuses findings. Despite treatment, he showed no clinical improvement. Ethmoidal sinus biopsies performed revealed extranodal NKTCL. Further imaging showed involvement of the right orbital contents and its adnexa with intracranial extension into the right cavernous sinus and meninges over right temporal fossa. The patient underwent chemotherapy. However he succumbed to his illness two months after the diagnosis. Conclusion: Extranodal NKTCL is a great mimicker. This case demonstrated how an acute initial presentation of extranodal NKTCL can present as orbital cellulitis with pansinusitis.

Matched MeSH terms: Orbital Cellulitis
In vitro antimicrobial efficacy of Cassia alata (Linn.) leaves, stem, and root extracts against cellulitis causative agent Staphylococcus aureus

Toh SC, Lihan S, Bunya SR, Leong SS

BMC Complement Med Ther, 2023 Mar 18;23(1):85.
PMID: 36934252 DOI: 10.1186/s12906-023-03914-z

BACKGROUND: Cellulitis is a common skin disease encountered in medical emergencies in hospitals. It can be treated using a combination of antibiotics therapy; however, the causative agent Staphylococcus aureus has been reported to develop resistance towards the currently used antibiotics. Therefore, the search for more alternative herbal origin antimicrobial agents is critical.
AIM: In this study, maceration and Soxhlet extraction of the whole plant of Cassia alata Linn. (leaves, roots, and stem) were performed using four solvents with different polarities, namely n-hexane, ethyl acetate, ethanol and distilled water. The crude extracts were screened using agar well diffusion, colorimetric broth microdilution, grid culture and bacterial growth curve analysis against Staphylococcus aureus. The phytochemicals in the crude extracts were identified using Gas Chromatography-Mass Spectrometry (GC-MS).
RESULTS: Agar-well diffusion analysis revealed that extraction using ethyl acetate showed the largest inhibition zone with an average diameter of 15.30 mm (root Soxhlet extract) followed by 14.70 mm (leaf Soxhlet extract) and 13.70 mm (root maceration extract). The lowest minimum inhibitory and minimum bactericidal concentration in root Soxhlet extract using ethyl acetate was 0.313 and 0.625 µg µL-1, respectively. Our study proved that crude extract of the plant suppressed the growth of S. aureus as evidenced from a significant regression extension (p

Matched MeSH terms: Cellulitis
Fulltext Pasteurella canis Isolation following Penetrating Eye Injury: A Case Report

Rashid NK, Zam Z, Mdnoor SS, Siti-Raihan I, Azhany Y

Case Rep Ophthalmol Med, 2012;2012:362369.
PMID: 22606491 DOI: 10.1155/2012/362369

A 3-year-old boy presented with history of trauma to the left eye after he accidentally injured his eye with a broom stick made up from coconut skewers. There was history of cats as their pets but not dogs. Ocular examination revealed left superonasal conjunctival laceration and scleral perforation with prolapsed vitreous. Fundus examination showed minimal vitreous haemorrhage and flat retina. Conjunctiva swab at the wound site was sent for gram staining, culture, and sensitivity. He underwent scleral suturing, vitreous tap, and intravitreal injection of Ceftazidime and Amikacin. Vitreous tap was sent for gram stained, culture and sensitivity. Postoperatively, he was started empirically on IV Ciprofloxacin 160 mg BD, Guttae Ciprofloxacin, and Guttae Ceftazidime. Conjunctiva swab grew Pasteurella canis which was sensitive to all Beta lactams, Ciprofloxacin, Chloramphenicol, and Aminoglycoside. Post-operative was uneventful, absent signs of endophthalmitis or orbital cellulitis.

Matched MeSH terms: Orbital Cellulitis
Fulltext Scedosporium apiospermum: A Rare Cause of Aggressive Orbital Apex Syndrome

Loh UL, Tai PY, Hussein A, A Qamarruddin F

Cureus, 2018 Dec 17;10(12):e3743.
PMID: 30800553 DOI: 10.7759/cureus.3743

Orbital apex syndrome (OAS) is a localized orbital cellulitis at the orbital apex that can cause vision loss from optic neuropathy and ophthalmoplegia involving multiple cranial nerves. Herein, we report a rare and rapidly progressive case of OAS secondary to fungal pansinusitis caused by Scedosporiumapiospermum in an immunocompromised patient following the extraction of abscessed teeth. A 48-year-old man with diabetes mellitus who had failed to adhere to his treatment presented with complaints of a right-sided headache and toothache for two weeks, with nausea and vomiting for two days prior to presentation. The patient was treated for septic shock secondary to the dental abscesses. Non-contrast brain computed tomography (CT) showed no significant intracranial abnormalities other than pansinusitis. Four days later, dental extraction was performed. The patient reported progressive painless blurring of the vision in his right eye following the dental extractions and was referred to the ophthalmology department. Subsequent examinations revealed decreased optic nerve function and ophthalmoplegia in his right eye and dental caries in the upper molars, with a mucopurulent discharge from the right sphenoid region. The clinical diagnosis was OAS. Pus near the orbital apex was drained surgically. Methicillin-resistant Staphylococcus aureus was isolated from the pus and a nasal swab. Tissue culture from the septal wall yielded S.apiospermum. The patient's condition deteriorated, despite intensive antibiotic and antifungal treatment and repeated surgical debridement. The disease progressed rapidly to his left eye. Sixty-seven days after the inital presentation, his visual acuity (VA) of both eyes was classified as no perception of light (NPL). The patient discharged himself from the hospital (at own risk discharge) and subsequently failed to attend a scheduled appointment in the ophthalmology clinic. If immunocompromised patients present with OAS, fungal infections should be ruled out. Prompt and aggressive treatment using a multidisciplinary approach is mandatory in cases of potentially life-threatening and vision-threatening fungal infections.

Matched MeSH terms: Orbital Cellulitis

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links