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Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Infantile maxillary sinus osteomyelitis mimicking orbital cellulitis
Nagarajan Krishnan1, Nathan Ramamoorthy2, Suresh Panchanathan2
1Department of Radiology, Chettinad Hospital & Research Institute, Kanchipuram, Tamil Nadu, India.
Insights
Osteomyelitis of the maxilla is rare in children. This case highlights a rare presentation of maxillary osteomyelitis in an infant with periorbital swelling and purulent nasal discharge.
Area of Science:
- Pediatric infectious diseases
- Maxillofacial pathology
Background:
- Periorbital swelling can stem from orbital or adjacent sinonasal inflammation.
- Maxillary osteomyelitis is uncommon in pediatric patients, especially with antibiotic availability.
Observation:
- An 11-month-old infant presented with periorbital swelling and purulent nasal discharge.
- Computed Tomography revealed maxillary sinus wall erosions, indicating osteomyelitis.
Findings:
- Staphylococcus aureus was identified from sinus scraping cultures.
- Intravenous cloxacillin treatment led to clinical improvement.
Implications:
- This case underscores the importance of considering maxillary osteomyelitis in infants with fever and periorbital swelling.
- Early diagnosis and treatment are crucial for favorable outcomes in rare pediatric infections.
Abstract:
Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling.
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