Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T11:31:17.492Z Has data issue: false hasContentIssue false
  • English
  • Français

Complicated periorbital cellulitis: case report and literature review

Published online by Cambridge University Press:  05 September 2011

N Parvizi ,
N Choudhury  and
A Singh
N Parvizi*
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, Northwick Park Hospital, North West London NHS Trust, Harrow, UK
N Choudhury
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, Northwick Park Hospital, North West London NHS Trust, Harrow, UK
A Singh
Affiliation:
Department of Otolaryngology - Head and Neck Surgery, Northwick Park Hospital, North West London NHS Trust, Harrow, UK
*
Address for correspondence: Dr Nassim Parvizi, North West London NHS Trust, Department of Otolaryngology - Head and Neck Surgery, Northwick Park Hospital, Harrow HA1 3UJ, UK Fax: +44 (0)208 869 2964 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Periorbital cellulitis secondary to rhinosinusitis is common. However, very rarely this can be complicated by a lacrimal gland abscess. We report such a case.

Method:

We present a case report and literature review concerning lacrimal gland abscess secondary to periorbital cellulitis.

Results:

Due to the location of this condition, prompt assessment and management is vital to avoid potential ophthalmological and neurological complications. Our patient failed to respond to initial conservative medical treatment, and was subsequently identified as having a lacrimal gland abscess, confirmed on contrast-enhanced computed tomography. Following definitive surgical treatment, the patient's clinical course improved. This case furthers our knowledge of this condition, and adds to the two previously reported paediatric cases.

Conclusion:

This case emphasises the importance of prompt management, and the fact that failure of clinical improvement following orbital decompression should alert the clinician to the rare possibility of an associated lacrimal gland abscess. The case also emphasises the key role of imaging and a multidisciplinary team approach when managing this condition.

Keywords

Orbital CellulitisLacrimal ApparatusAbscessComputed Tomography
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 94 - 96
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Pereira, KD, Mitchell, RB, Younis, RT, Lazar, RH. Management of medial subperiosteal abscess of the orbit in children: a 5 year experience. Int J Pediatr Otorhinolaryngol 1997;38:247–54CrossRefGoogle Scholar
2Chandler, JR, Langenbrunner, DJ, Stevens, ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970;80:1414–28CrossRefGoogle ScholarPubMed
3Patel, N, Khalil, HMB, Amirfeyz, R, Kaddour, HS. Lacrimal gland abscess complicating acute sinusitis. Int J Pediatr Otorhinolaryngol 2003;67:917–19CrossRefGoogle ScholarPubMed
4Guss, J, Kazahaya, K. Bilateral lacrimal gland abscesses. Int J Pediatr Otorhinolaryngol 2006;1:5–8CrossRefGoogle Scholar
5Ferguson, MP, McNab, AA. Current treatment and outcome in orbital cellulitis. Aust N Z J Ophthalmol 1999;27:375–9Google ScholarPubMed
6Sridhara, SR, Paragache, G, Panda, NK, Chakrabarti, A. Mucormycosis in immunocompetent individuals: an increasing trend. J Otolaryngol 2005;34:402–6CrossRefGoogle ScholarPubMed
7Hubert, L. Orbital infections-due to nasal sinusitis. New York Journal of Medicine 1937;37:1559–1564Google Scholar
8Smith, AT, Spencer, JT. Orbital complications resulting from lesions of the sinuses. Ann Otol Rhinol Laryngol 1948;57:5–27CrossRefGoogle ScholarPubMed
9Blake, FAS, Siegert, J, Gbara, A. The acute orbit: etiology, diagnosis, and therapy. J Oral Maxillofac Surg 2006;64:87–93CrossRefGoogle ScholarPubMed
10Schramm, VL, Myers, EN, Kennerdell, JS. Orbital complications of acute sinusitis: evaluation, management, and outcome. Otolaryngology 1978;86:221–30CrossRefGoogle ScholarPubMed
11Moloney, JR, Badham, NJ, McRae, A. The acute orbit. Preseptal (periorbital) cellulitis, subperiostal abscess and orbital cellulitis due to sinusitis. J Laryngol Otol Suppl 1978;12:1–18Google Scholar
12Bhargava, D, Sankhla, D, Gaensan, A, Chand, P. Endoscopic sinus surgery for orbital subperiosteal abscess secondary to sinusitis. Rhinology 2001;39:151–5Google ScholarPubMed
13Capps, EF, Kinsella, JJ, Gupta, M, Bhatki, AM, Opatowsky, MJ. Emergency imaging assessment of acute, nontraumatic conditions of the head and neck. Radiographics 2010;30:1335–52Google ScholarPubMed
14Eustis, HS, Mafee, MF, Walton, C, Mondonca, J. MR imaging and CT of orbital infections and complications in acute rhinosinusitis. Radiol Clin North Am 1998;36:1165–83CrossRefGoogle ScholarPubMed
15Herrmann, BW, Forsen, JW. Simultaneous intracranial and orbital complications of acute rhinosinusitis in children. Int J Pediatr Otorhinolaryngol 2004;68:619–25CrossRefGoogle ScholarPubMed
16McNab, AA. Lacrimal gland abscess: two case reports. Aust N Z J Ophthalmol 1999;27:75–8CrossRefGoogle ScholarPubMed
17Ntountas, I, Morschbacher, R, Pratt, D, Patel, BC, Anderson, RL, McCann, JD. An orbital abscess secondary to acute dacryocystitis. Ophthalmic Surg Lasers 1997;28:758–61CrossRefGoogle ScholarPubMed
18Mirza, S, Lobo, CJ, Counter, P, Farrington, WT. Lacrimal gland abscess: an unusual complication of rhinosinusitis. ORL J Otorhinolaryngol Relat Spec 2001;63:379–81CrossRefGoogle ScholarPubMed