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Published on: May 21, 2018
Septic pulmonary embolism associated with orbital abscess and sinusitis
1Kresge Eye Institute, Department of Ophthalmology, Wayne State University, Detroit, MI 48201, USA.
Ophthalmic Plastic and Reconstructive Surgery
|April 7, 2007
Summary
A pediatric patient with preseptal cellulitis developed a complex orbital abscess and septic pulmonary embolism. Prompt surgical drainage and antibiotics led to significant clinical improvement and near-resolution of lung lesions.
Area of Science:
- Ophthalmology
- Pediatric Infectious Diseases
- Thoracic Medicine
Background:
- Preseptal cellulitis can rarely progress to orbital complications.
- Orbital abscesses pose diagnostic and therapeutic challenges, especially when deep-seated.
Observation:
- A 13-year-old boy presented with preseptal cellulitis, progressing to an undiagnosed orbital abscess.
- Initial surgical exploration failed to locate the abscess, followed by the development of acute chest pain and bilateral pulmonary lesions.
- Computed tomography (CT) revealed septic pulmonary embolism, prompting further investigation.
Findings:
- Re-exploration of the orbit successfully drained an intraconal orbital abscess.
- Intravenous antibiotics were administered for both the orbital infection and the pulmonary embolism.
- The patient showed marked improvement in orbital cellulitis and chest pain.
Implications:
- This case highlights the potential for severe systemic complications, such as septic pulmonary embolism, originating from orbital infections.
- Early and accurate diagnosis, including advanced imaging, is crucial for managing complex orbital abscesses.
- Multidisciplinary management involving ophthalmology, infectious disease, and pulmonology is essential for favorable outcomes in such cases.
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