Pansinusitis with orbital cellulitis

Abstract

Introduction: We report a rare case of pan sinusitis with orbital cellulitis in a 3-year-old male child. Orbital cellulitis is considered as an ocular emergency which needs urgent evaluation and proper quick action to save the patient vision or even life. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. Methods: A 3-year-old male child presented to us with history of fever since 15 days. Later he developed swelling of left eye lid since 8 days. His visual acquity was fixating and following light. On anterior segment examination there was diffuse upperlid edema of left eye associated with mild erythema and matting of lashes. On MRI, it shows left sided pansinusitis with orbital cellulitis. Results: In view of left sided pansinusitis with orbital cellulitis, Functional Endoscopic Sinus Surgery with orbital decompression was done. Pus from the middle meatus was taken, sent for culture and sensitivity and the organism isolated was methicillin resistant Staphylococcus aureus (MRSA) positive growth and child was continued on antibiotics i.e., Teicoplanin and Metrogyl. Patient showed marked improvement in both ocular and general condition. Conclusion: Currently, imaging studies for detection of orbital abscess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention. This case report will be of interest particularly to the ophthalmologists, the otorhinolaryngologists, and the paediatricians.

Keywords

• pansinusitis
• intracranial extension
• orbital abscess
• orbital cellulitis
• vision loss