RESUMEN
PURPOSE: To report a rare case of lymphocutaneous Nocardia brasiliensis originating in the eyelid. DESIGN: Observational case report. METHODS: The clinical presentation, workup, and treatment of a case of lymphocutaneous Nocardia brasiliensis originating in the eyelid are presented. RESULTS: The patient presented with a preseptal cellulitis from an abrasion of the eyelid that progressed to submandibular lymph node suppuration. Culture was performed, and a diagnosis of lymphocutaneous Nocardia brasiliensis was made. CONCLUSION: Nocardia brasiliensis may cause a lymphocutaneous infection of the face and must be considered in the differential diagnosis of preseptal cellulitis.
Asunto(s)
Infecciones Bacterianas del Ojo/microbiología , Enfermedades de los Párpados/microbiología , Enfermedades Linfáticas/microbiología , Nocardiosis/microbiología , Nocardia/aislamiento & purificación , Enfermedades Cutáneas Bacterianas/microbiología , Anciano , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Enfermedades de los Párpados/diagnóstico , Enfermedades de los Párpados/tratamiento farmacológico , Humanos , Ganglios Linfáticos/microbiología , Ganglios Linfáticos/patología , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/tratamiento farmacológico , Masculino , Nocardiosis/diagnóstico , Nocardiosis/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
Wegener's granulomatosis (WG) is a rare, idiopathic, systemic vasculitis of small vessels that manifests in multiple organ systems. Otorhinolaryngic manifestations of this disease include recurrent sinusitis and relapsing polychondritis. Periocular involvement is also a well-documented location of Wegener's disease. We present the case of a 13-year-old girl with severe WG who developed multiple recurrent orbital infections. She underwent multiple incision and drainage surgeries of each orbit and multiple courses of intravenous antibiotics. The patient persistently reaccumulated purulence in her nasolacrimal duct system and was referred to an oculoplastic surgeon for evaluation of these recurrent infections. The diagnosis of dacryocystitis as a complication of WG was made. This unique case represents a patient with severe WG developing bilateral dacryocystitis requiring bilateral dacryocystorhinostomies.