Orbital Cellulitis and Endophthalmitis in Pseudomonas Septicemia

Luemsamran, Panitee; Pornpanich, Kanograt; Vangveeravong, Sumalee; Mekanandha, P

doi:10.1080/01676830802350422

Cited by 13 publications

(6 citation statements)

References 8 publications

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“…[34] A similar report involved the concurrent presentation of EG with orbital cellulitis and endophthalmitis – a less extensive involvement of the orbital tissues than panophthalmitis. [35] More commonly observed are reports of periorbital EG, which was also present on the right eyelid of our patient. [363738]…”

Section: Discussionsupporting

confidence: 56%

Fatal oculocutaneous ecthyma gangrenosum in human immunodeficiency virus/acquired immunodeficiency syndrome: Case report and review of the literature

Henshaw

Ibanga

Obaji

2019

J Global Infect Dis

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Ecthyma gangrenosum (EG) is a rare, infective skin disease, predominantly but not exclusively caused by Pseudomonas aeruginosa . It is often seen in individuals with immunosuppression, although it has also been reported among previously healthy individuals. It was initially thought to be pathognomonic of P. aeruginosa septicemia, but this assertion was discarded following several reports on EG without bacteremia and EG with varied bacterial and fungal etiologies. There are scant reports of its association with human immunodeficiency virus (HIV) infection, while ocular involvement is extremely rare. An extensive search of the literature also found no report on EG, nor its relationship with HIV/acquired immunodeficiency syndrome (AIDS) from Sub-Saharan Africa. We hereby present a fatal case of multiple EG lesions in a 44-year-old Nigerian female with AIDS in the absence of bacteremia and review the literature of its association with HIV/AIDS and its concurrent orbital involvement.

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Section: Discussionsupporting

confidence: 56%

Fatal oculocutaneous ecthyma gangrenosum in human immunodeficiency virus/acquired immunodeficiency syndrome: Case report and review of the literature

Henshaw

Ibanga

Obaji

2019

J Global Infect Dis

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“…Orbital inflammatory conditions are considered to be either infectious or noninfectious in origin and originate from neighboring tissue such as the nasal or paranasal sinuses, oral cavity, tooth root, ocular surface, or intraocular structures. Orbital infections typically form granulomas, 39 abscesses, 24 or cellulitis 40 and are a result of bacterial, 41 fungal, 42 or parasitic infections, 43 as well as penetrating foreign bodies 44 . Significant periocular swelling, pain on retropulsion of the globe and oral manipulation is typically noted on clinical examination.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of orbital nodular granulomatous episcleritis in a dog

Barnes

Pearce

Berent

et al. 2010

Veterinary Ophthalmology

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A 27 kg, 6-year-old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well-circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en-bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.

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“…5 Concurrent cellulitis and endophthalmitis that resulted from endogenous complications have been reported in the literature but are usually caused by Gram-negative microorganisms. 12,13 Unfortunately, the first option of treatment was evisceration in both cases because the visual acuity of these patients was NLP and, therefore, they were without visual prognosis. The evisceration can give to these patients a better outcome and fast relief of the ocular symptoms.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis: A Rare but Devastating Metastatic Bacterial Complication of Hemodialysis Catheter-Related Sepsis

Lima

Cecchetti²,

Cecchetti³

et al. 2011

Renal Failure

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There are many infectious complications related to vascular access in patients undergoing maintenance hemodialysis. We report two cases of endophthalmitis as a metastatic infection associated with a tunneled catheter and a temporary dual lumen catheter. Both patients were diabetic. A 61-year-old female on maintenance hemodialysis by a jugular tunnelized catheter during the past year was receiving parenteral antibiotics for catheter salvage due to fever episodes in the last 3 months. She was admitted to the hospital presenting pain, proptosis, conjunctival hyperemia, corneal infiltrate, and visual acuity of no light perception (NLP). A 51-year-old male recently undergoing hemodialysis by a temporary dual lumen catheter presented fever. His catheter was removed, but he was admitted to the hospital presenting fever, decreased vision, edema, and pain in his left eye. On examination, eyelid edema, conjunctival hyperemia, purulent secretion, hypopyon in the pupils, and visual acuity of NLP were verified. A diagnosis of endogenous endophthalmitis was made in both patients on clinical grounds and computed tomography. Evisceration of the left eye was the first option of treatment for both patients due to poor vision. Cultures of the eviscerated ocular globes showed Staphylococcus hemolyticus and Staphylococcus aureus, respectively. After evisceration, both patients received treatment, had a good outcome, and were discharged to continue their hemodialysis program. Metastatic bacterial endophthalmitis is a rare complication of dialysis catheter-related bacteremia. When suspected, urgent ophthalmologic evaluation and treatment are needed to reduce the risk of losing vision in the affected eye.

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Orbital Cellulitis and Endophthalmitis in Pseudomonas Septicemia

Cited by 13 publications

References 8 publications

Fatal oculocutaneous ecthyma gangrenosum in human immunodeficiency virus/acquired immunodeficiency syndrome: Case report and review of the literature

Fatal oculocutaneous ecthyma gangrenosum in human immunodeficiency virus/acquired immunodeficiency syndrome: Case report and review of the literature

Surgical management of orbital nodular granulomatous episcleritis in a dog

Endophthalmitis: A Rare but Devastating Metastatic Bacterial Complication of Hemodialysis Catheter-Related Sepsis

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