Bacterial orbital infection leading to orbital exenteration: a case series

Orbital exenteration (OE) secondary to infection is rare. This case series reports 3 cases and aims to elucidate the possible underlying etiopathogenesis. A retrospective data analysis was performed of patients who underwent an OE and subsequently received an orbital prosthesis from the Dutch Institute for Facial Prosthetics between 2017 and 2024. Only cases secondary to infection were included. Of the 44 cases treated, only 3 were infection related. An odontogenic infection was the underlying cause in 2 cases, a periorbital/orbital necrotizing fasciitis due to a skin infection in the third case. All cases presented with clinical signs of orbital compartment syndrome and underwent multiple drainage procedures; nevertheless, OE was ultimately required in each case as a life-saving intervention. Remarkably, in all three cases, the infection was bacterial and the individuals were in good health at the time of diagnosis. One individual, however, had a history of cancer but had been in complete remission for more than 6 months. Although such cases are exceedingly rare, they underscore the importance of prompt recognition and adequate treatment of infections, even in otherwise healthy individuals.