RESUMEN
A 33-year-old woman with a history of relapsing-remitting multiple sclerosis presented with complaints of episodic horizontal diplopia and blurred vision over the past two months. The patient gave a past history of similar episodes of diplopia that had occurred with previous clinical relapses of her multiple sclerosis. On eye movement examination, the patient exhibited intermittent spasms of convergence coupled with miosis. On upward gaze, the convergence and miosis became more marked. An auto-refraction revealed variable measurements in both eyes, consistent with accommodative spasms. A cycloplegic auto-refraction revealed significantly lower myopia present in both eyes than the initial pre-cycloplegic auto-refraction with minimal variability in readings. Symptomatic relief was achieved by cycloplegia and spectacle correction.
Asunto(s)
Acomodación Ocular , Convergencia Ocular , Miosis/etiología , Esclerosis Múltiple/complicaciones , Espasmo/etiología , Femenino , Estudios de Seguimiento , Humanos , Miosis/fisiopatología , Espasmo/fisiopatologíaRESUMEN
Pott's puffy tumor is rarely associated with orbital cellulitis. We describe a pediatric patient with Pott's puffy tumor and right-sided orbital cellulitis. He underwent urgent surgical drainage of a glabellar subperiosteal abscess and completed a six week course of intravenous antibiotics with complete resolution of infection and no long-term sequelae. Close monitoring with imaging for intracranial spread and multidisciplinary surgical intervention are commonly recommended.
Asunto(s)
Celulitis (Flemón)/etiología , Edema/etiología , Absceso Epidural/complicaciones , Enfermedades de los Párpados/etiología , Sinusitis Frontal/complicaciones , Enfermedades Orbitales/etiología , Osteomielitis/complicaciones , Ampicilina/administración & dosificación , Antibacterianos/uso terapéutico , Celulitis (Flemón)/diagnóstico por imagen , Celulitis (Flemón)/terapia , Niño , Terapia Combinada , Drenaje/métodos , Edema/diagnóstico por imagen , Edema/terapia , Absceso Epidural/diagnóstico por imagen , Absceso Epidural/terapia , Enfermedades de los Párpados/diagnóstico por imagen , Enfermedades de los Párpados/terapia , Sinusitis Frontal/diagnóstico por imagen , Sinusitis Frontal/terapia , Humanos , Infusiones Intravenosas , Masculino , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades Orbitales/terapia , Osteomielitis/diagnóstico por imagen , Osteomielitis/terapia , Sulbactam/administración & dosificación , Tomografía Computarizada por Rayos XRESUMEN
A 48-year-old woman presented with a 5-month history of unilateral epiphora and progressive growth of a left-sided medial canthus mass. CT revealed a nonenhancing soft tissue mass of the left lacrimal sac with widening and erosion of the nasolacrimal canal. The tumor was resected and pathologically confirmed to be malignant melanoma. Despite wide resection and adjuvant radiotherapy, the patient developed metastases to the chest wall. The patient currently is receiving combined immunotherapy and chemotherapy. The clinical course and treatment strategies are reviewed for this highly aggressive and rare neoplasm.