MRSA Cellulitis with Orbital and Retinal Abscesses Resulting in Lemierre Syndrome Following Eyebrow Piercing

The authors describe a case of orbital cellulitis with abscess formation following eyebrow piercing complicated by internal jugular vein thrombosis and subretinal abscesses requiring enucleation with orbital abscess drainage. The popularity of body piercing is increasing and physicians should be familiar with the possibility and management of vision-threatening complications of facial piercing. Following left eyebrow piercing, a 20-year-old female experienced increasing periorbital swelling, erythema, chemosis, orbital pain, decreased vision, and concomitant fever, chills, and rhinorrhea. She was found to have left orbital cellulitis with multiple orbital abscesses, intracranial thromboses, internal jugular vein thrombosis, and septic pulmonary emboli consistent with Lemierre syndrome. Treatment of her condition included broad-spectrum intravenous antibiotics, anticoagulation, orbital abscess drainage, and ultimately OS enucleation. To the authors' knowledge, this is the first case of orbital infection and Lemierre syndrome following eyebrow piercing.