Necrotizing Orbital Cellulitis Secondary to Odontogenic Streptococcus constellatus

Area of Science:

• Ophthalmology
• Infectious Diseases
• Oral Surgery

Background:

• Orbital cellulitis is a serious infection that can lead to vision loss.
• Odontogenic infections, originating from dental structures, are a common cause of orbital cellulitis.
• Streptococcus constellatus is a bacterial species frequently implicated in odontogenic infections.

Observation:

• A 69-year-old woman presented with orbital cellulitis secondary to an odontogenic Streptococcus constellatus infection.
• The patient's infection was refractory to intravenous antibiotics, necessitating surgical intervention.
• Surgical debridement was performed with preservation of the ocular globe.

Findings:

• The patient recovered full ocular motility following surgical debridement.
• Despite successful management of the infection and globe preservation, visual recovery was compromised by optic nerve ischemia.
• This outcome highlights a potential complication even with appropriate surgical timing.

Implications:

• This case underscores the critical need for timely surgical drainage in managing necrotizing orbital infections, particularly those of odontogenic origin.
• Early surgical intervention is vital to prevent vision-threatening complications and preserve ocular function.
• The findings emphasize the importance of a multidisciplinary approach involving ophthalmology, infectious disease, and dental surgery specialists.