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Orbital Cellulitis Presenting as Giant Cell Arteritis: A Case Report.

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Summary

Orbital cellulitis can mimic giant cell arteritis in older adults presenting with headaches. Prompt brain MRI with contrast is crucial for diagnosing this serious orbital infection.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Infectious Diseases

Background:

  • Giant cell arteritis (GCA) is a common vasculitis in older adults, often presenting with headaches.
  • Orbital cellulitis is a serious infection that can cause vision loss and requires prompt treatment.

Observation:

  • An 80-year-old male with hypertension and diabetes presented with progressive unilateral headache mimicking GCA.
  • Initial investigations showed elevated ESR, but symptoms worsened despite corticosteroid treatment.
  • Brain MRI revealed extensive orbital inflammation along the optic nerve and optic canal, suggestive of orbital cellulitis.

Findings:

  • The patient was diagnosed with orbital cellulitis caused by Pseudomonas aeruginosa.
  • Successful treatment involved intravenous antibiotics and surgical drainage.

Implications:

  • Orbital cellulitis should be considered in the differential diagnosis of unilateral headaches in elderly patients, especially when GCA is suspected.
  • Contrast-enhanced brain MRI is essential for identifying orbital infections and differentiating them from other intracranial pathologies.