Abstract
Purpose To report 2 cases of severe necrotising orbital cellulitis which illustrate the need for aggressive surgical management to prevent blindness.
Methods The case records of 2 patients with necrotising orbital cellulitis were reviewed.
Results Both patients had orbital cellulitis associated with sinusitis. Each case was characterised by the rapid development of severe systemic toxicity, extensive soft tissue necrosis and abscess formation. One patient developed panophthalmitis and the eye had to be eviscerated. The other patient underwent repeated surgical drainage of multiple orbital abscesses. This led to resolution of the infection and preservation of vision.
Conclusions Atypical rapidly progressive necrotising orbital cellulitis may occasionally be encountered. In such cases, aggressive surgical drainage of orbital abscesses is crucial to prevent blindness and death.
Similar content being viewed by others
Article PDF
References
Noel LP, Clarke WN, MacDonald N . Clinical management of orbital cellulitis in children. Can J Ophthalmol 1990;25:11–6.
Rubin SE, Rubin LG, Zito J, et al. Medical management of orbital subperiosteal abscess in children. J Pediatr Ophthalmol Strabismus 1989;26:21–7.
Catalano RA, Smoot CN . Subperiosteal orbital masses in children with orbital cellulitis: time for a re-evaluation? J Pediatr Ophthalmol Strabismus 1990;27:141–2.
Lemke BN, Gonnering RS, Weinstein JM . Orbital cellulitis with periosteal elevation. Ophthalmic Plast Reconstr Surg 1987;3:1–7.
El-Silimy O . The place of endonasal endoscopy in the treatment of orbital cellulitis. Rhinology 1995;33:93–6.
Seah LL, Fu ERY . Acute orbital cellulitis: a review of 17 cases. Ann Acad Med Singapore 1997;26:409–14.
Hodges E, Tabbara KF . Orbital cellulitis: review of 23 cases from Saudi Arabia. Br J Ophthalmol 1989;73:205–8.
Bergin DJ, Wright JE . Orbital cellulitis. Br J Ophthalmol 1986;70:174–8.
Hofbauer JD, Gordon LK, Palmer J . Acute orbital cellulitis after peribular injection [letter]. Am J Ophthalmol 1994;118:391–2.
McLeod SD, Flowers CW, Lopez PF, Marx J, McDonnell PJ . Endophthalmitis and orbital cellulitis after radial keratotomy. Ophthalmology 1995;102:1902–7.
Burns SJ, Scott JA, Hiscott PS, Hebbar G, Kamaruddin K, Jalili IK . E. coli panophthalmitis with orbital cellulitis [letter]. Eye 1997;11:436–8.
Kingston D, Seal DV . Current hypotheses on synergistic microbial gangrene. Br J Surg 1990;77:260–4.
Singh KP, Morris A, Lang SDR, et al. Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases. NZ Med J 1988;101:813–6.
Rouff KL . Streptococcus anginosus (Streptococcus milleri): the unrecognised pathogen. Clin Microbiol Rev 1988;1:102–8.
Mandell GL, Bennett JE, Dollin R . Principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone, 1995:1861–4.
Marrie TJ, Bent JM, West AB, et al. Extensive gas in tissues of the forearm after horsebite. Southern Med J 1979;72:1473–4.
Donahue SP, Schwartz G . Preseptal and orbital cellulitis in childhood: a changing microbiologic spectrum. Ophthalmology 1998;105:1902–5.
Barone SR, Aiuto LT . Periorbital and orbital cellulitis in the Haemophilus influenzae vaccine era. J Pediatr Ophthalmol Strabismus 1997;35:293–6.
Steel A . An unusual case of necrotizing fasciitis. Br J Oral Maxillofacial Surg 1987;25:328–33.
Shayegani A, MacFarlane D, Kazim M, et al. Streptococcal gangrene of the eyelids and orbit. Am J Ophthalmol 1995;120:784–92.
Holliman RE, Catford GV . Periorbital necrotizing fasciitis with loss of vision. J Infect 1986;13:35–6.
Ferguson MP, McNab AA . Current treatment and outcome in orbital cellulitis. Aust NZ J Ophthalmol 1999;27:375–9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ng, S., Nazir, R., Sabhudi, C. et al. Necrotising orbital cellulitis. Eye 15, 173–177 (2001). https://doi.org/10.1038/eye.2001.55
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.2001.55
Keywords
This article is cited by
-
Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report
BMC Ophthalmology (2021)
-
Necrotising fasciitis of the paranasal sinuses
European Archives of Oto-Rhino-Laryngology (2017)