Complete manuscript title: Neurological complications from sinugenic orbital cellulitis

Introduction: This study was undertaken with an aim to identify any common factors or trends among patients of orbital cellulitis that developed neurological complications. Methods: A 24-month retrospective review of patients was undertaken to include those showing clinical deterioration and neurological complications on radiological imaging, after being treated for orbital cellulitis at Manchester Royal Eye Hospital. The study specifically looked at the site of orbital collection, sinus involvement, types of neurological complications and whether these were detected at initial presentation, surgical input and microbiology findings. Results: Nine patients (9/26) developed associated neurological complications during the study period. (February 2018 and January 2020) This included subdural empyema in six patients; leptomeningeal enhancement in two and septic emboli in one patient. All the patients had associated significant pan-sinusitis at initial presentation. Neurological complications were detected in three patients at the time of admission and after clinical deterioration and further investigations in the rest. Conclusion: A superior orbital abscess and Streptococcus mileri infection had higher risk of neurological complications. It is worth debating whether patients with chronic sinusitis who develop orbital cellulitis need earlier surgical input rather than a conservative treatment. Patients who fail to improve clinically need to be re-imaged to look for possible neurological complications.

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Unexplained worsening of parkinsonian symptoms in a patient with advanced Parkinson’s disease as the sole initial presentation of COVID-19 infection: a case report

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00314-3 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Walaa A. Kamel ◽

Ismail Ibrahim Ismail ◽

Mohamed Ibrahim ◽

Jasem Y. Al-Hashel

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Viral Infections ◽

Neurological Complications ◽

Initial Presentation ◽

Nasopharyngeal Swab ◽

Initial Manifestation ◽

Advanced Parkinson’S Disease ◽

Case Presentation ◽

Dystonic Posturing

Abstract Background Parkinson’s disease (PD) is a neurodegenerative condition that has been reported following viral infections in rare occasions. Several neurological complications have emerged in association with coronavirus disease 2019 (COVID-19), since its declaration as a pandemic. Herein, we present a novel case of unexplained worsening of PD as the sole initial presentation of COVID-19, in the absence of fever or respiratory symptoms. Case presentation A 56-year-old male with advanced PD presented with severe rigidity, dystonic posturing of both feet, and confusion of 4 days duration. His condition progressed to an akinetic-rigid state and confusion during the following week, and a routine nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the 9th day of onset. He developed fever and dyspnea later and was intubated on the 10th day. Conclusion To our knowledge, worsening of PD symptoms as the sole initial manifestation of SARS-CoV-2 infection, in the absence of other cardinal features of COVID-19, has not been reported in the literature. We suggest testing for COVID-19 infection in patients with PD, especially advanced cases, who present with unexplained worsening of symptoms, even in the absence of COVID-19 cardinal features.

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Orbital Cellulitis in Children: Experience of the Pediatric Service at Mohammed v Military Hospital

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2021/v7i330216 ◽

2021 ◽

pp. 6-9

Author(s):

Jihane Elmahi ◽

A. Radi ◽

M. Kmari ◽

A. Hassani ◽

R. Abilkasseme ◽

...

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Orbital Cellulitis ◽

Military Hospital ◽

Preseptal Cellulitis ◽

Orbital Abscess ◽

Pediatric Service ◽

Micro Organisms ◽

Positive Evolution ◽

Multidisciplinary Patient Care

Background: Orbital cellulitis is a diagnostic and therapeutic emergency, jeopardizing the vital and functional prognosis. This study aimed to analyze the epidemiological, therapeutic and evolutional aspects of orbital cellulitis cases treated at the pediatric service at Mohamed V military hospital. Patients and methods: retrospective study including all the children aged between 1 month and 15 years treated for orbital cellulitis at the pediatric service of the Mohamed V Hospital over a period of 3 years (1st January 2016-31st December 2019). Results: 24 cases of orbital cellulitis were gathered. Age varied between 1 month and 15 years with a median of age of 6. years. Feminine predominance (58%) was noted . The disease mainly involved the sinus (32%).Clinically, fever was present in 10 patients (41%),palpebral edema was universal, proptosis was noted in 5 cases(20.8%),chemosis and ptosis were noted in 4 cases(16.6%),bacteriological testing identified micro-organisms in 3 cases. An orbital CT scan was performed in all cases of our study, showing preseptal cellulitis in 14 cases (58.3%), orbital cellulitis in 3 cases(12.5%),and orbital abscess in 7 cases. The medical treatment consisted of ceftriaxone, metronidazole and aminoside or amoxicilline clavulanic acid, corticosteroid therapy prescribed in 5 cases. Surgical treatment was indicated in 3 patients. The outcome of All cases was favorable. Conclusion: The majority of our cases had a positive evolution highlighting the advantage of an early diagnosis, and adapted antibiotic and a multidisciplinary patient care making the need for surgery rarely necessary.

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A Case of Acute Dacryocystitis Diagnosed after Surgical Treatment of Orbital Cellulitis and Orbital Abscess

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2019.60.1.69 ◽

2019 ◽

Vol 60 (1) ◽

pp. 69

Author(s):

Min Gu Huh ◽

Jong Myung Yun ◽

Mi Seon Kwak

Keyword(s):

Surgical Treatment ◽

Orbital Cellulitis ◽

Orbital Abscess

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Naso-orbital fracture leading to orbital cellulitis, and visual loss as a complication of chronic sinusitis

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/0266-4356(94)90132-5 ◽

1994 ◽

Vol 32 (2) ◽

pp. 80-82 ◽

Cited By ~ 17

Author(s):

A.W. Paterson ◽

N.A. Barnard ◽

G.H. Irvine

Keyword(s):

Visual Loss ◽

Chronic Sinusitis ◽

Orbital Cellulitis ◽

Orbital Fracture

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Bedside ultrasound in the diagnosis of orbital cellulitis and orbital abscess

Emergency Radiology ◽

10.1007/s10140-011-0993-0 ◽

2012 ◽

Vol 19 (3) ◽

pp. 265-267 ◽

Cited By ~ 2

Author(s):

Charlotte Derr ◽

Ankit Shah

Keyword(s):

Orbital Cellulitis ◽

Bedside Ultrasound ◽

Orbital Abscess

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Orbital Cellulitis and Orbital Abscess of Odontogenic Origin: Two Case Reports and Literature Review

International Journal of Dentistry and Oral Health ◽

10.16966/2378-7090.206 ◽

2016 ◽

Vol 2 (7) ◽

Author(s):

Ahmed KA

Keyword(s):

Literature Review ◽

Case Reports ◽

Orbital Cellulitis ◽

Orbital Abscess ◽

Odontogenic Origin

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Management of Periorbital and Orbital Cellulitis at the Pediatric Emergency Department

10.21203/rs.3.rs-29291/v1 ◽

2020 ◽

Author(s):

Widad Lahmini ◽

mounir bourrous

Keyword(s):

Soft Tissues ◽

Pediatric Emergency ◽

Orbital Cellulitis ◽

University Hospital ◽

Emergency Unit ◽

Bacteriological Study ◽

Subperiosteal Abscess ◽

Preseptal Cellulitis ◽

Orbital Abscess ◽

Positive Evolution

Abstract Background : Orbital cellulitis is a diagnostic and therapeutic emergency, jeopardizing the vital and functional prognosis. This study aimed to analyze the epidemiological, therapeutic and evolutional aspects of orbital cellulitis cases treated at the pediatric emergency unit. Patients and methods: retrospective study including all the children aged between 1 month and 15 years treated for orbital cellulitis at the pediatric emergency unit of the Mohamed VI University Hospital of Marrakech over a period of 9 years (1st January 2010-31st December 2018). Results: 129 cases of orbital cellulitis were gathered. Age varied between 1 month and 15 years with a median of age of 4.3 years. Feminine predominance (54%) was noted (sex ratio of 0.84). Preseptal cellulitis had the lead with 101 cases (78.2%). It mainly breaks through sinuses (24%). Fever was present in 101 patients (78.2%). Palpebral edema was constant. Exophthalmia was noted in 18 patients (13.9%), chemosis in 29 cases (22.4%) while ptosis was found in one patient. Bacteriological study conducted in 12 cases was positive in 7 cases. An orbital CT scan was performed in all cases of our study, showing preseptal cellulitis in 101 patients (78.2%), orbital cellulitis in 11 cases (8.5%), subperiosteal abscess in 15 cases (11.6%) and orbital abscess in 2 cases (1.5%). The medical treatment consisted of ceftriaxone, metronidazole and aminoside or amoxicilline clavulanic acid. Surgical treatment was indicated in 8 patients : 3 cases of orbital abscess, 2 cases of periosteal abscess, and 3 cases of abscessed collection of the soft tissues. The evolution was beneficial in all our patients. Conclusion: The majority of our cases had a positive evolution highlighting the advantage of an early diagnosis, and adapted antibiotic and a multidisciplinary patient care making the need for surgery rarely necessary.

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Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report

BMC Ophthalmology ◽

10.1186/s12886-021-02153-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Atsuhide Takesue ◽

Yosuke Asada ◽

Hiroki Ooya ◽

Toshiyuki Yokoyama

Keyword(s):

Ocular Surface ◽

Corneal Ulcer ◽

Chronic Sinusitis ◽

Orbital Cellulitis ◽

Blowout Fracture ◽

Obligate Anaerobic ◽

Parvimonas Micra ◽

Chronic Periodontal Disease ◽

The Right ◽

Head Computed Tomography

Abstract Background Parvimonas micra is known as a causative agent of chronic periodontal disease. This Gram-positive obligate anaerobic coccus was cultured from the ocular surface of blowout fracture-related orbital cellulitis progressing to panophthalmitis. Case presentation The patient was a woman in her fifties who had panic disorder and subsequently was a victim of domestic violence. These factors led to delayed consultation. At the initial visit to an ophthalmologist, the ocular surface of the right eye was covered with pus. Swelling of the upper and lower eyelids prevented the eyelid from closing and exophthalmos, severe corneal ulcer, panophthalmitis, and no light perception were observed. Head computed tomography revealed an old blowout fracture and chronic sinusitis with orbital cellulitis. P. micra were isolated from culture of pus samples from the sinus and from the ocular surface. Conclusions There is a possibility that P. micra invaded the orbit via the fragile bony site and caused orbital cellulitis, severe corneal ulcer, and panophthalmitis that required enucleation. In cases of coexisting old blowout fracture and chronic sinusitis, the chronic sinusitis should be treated as quickly as possible.

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