Pseudomonas orbital cellulitis

A 3-month-old infant being treated for bronchitis developed a rapid onset but otherwise typical orbital cellulitis. Because gram-negative infections and septicemia are common occurrences in the newborn nursery, this patient was given systemic gentamicin and ampicillin. Sinus x-rays were not attempted. Two days after treatment the eyelids were opened. A strikingly large corneal ulcer with perforated globe and endophthalmitis was found. Pseudomonas aeroginosa was cultured from the blood, conjunctiva, and throat. A diagnosis of Pseudomonas orbital cellulitis with secondary corneal perforation and endophthalmitis was made. The source of infection was believed to be the respiratory tract.