RESUMEN
OBJECTIVE: To report new cases of orbital inflammatory syndrome (OIS) post group A streptococcal (GAS) infection and review the literature. METHODS: A retrospective case series of patients with OIS post GAS infection seen in our clinic (from January 2015 to December 2016) and review of additional patients from the literature. RESULTS: A total of nine patients with OIS post GAS infection were included in the study (four patients seen in our clinic and five from previous literature); seven females and two males, three children (under the age of 16), and six adults. Eight patients (89%) presented with a single rectus muscle (5 medial, 3 lateral) myositis, and one (11%) presented with posterior scleritis and diffuse OIS. CONCLUSIONS: Although there are very few reports on OIS post GAS infection, it may be more common than previously thought and should be considered in the differential diagnosis of patients with orbital inflammation.
Asunto(s)
Infecciones Bacterianas del Ojo/diagnóstico , Seudotumor Orbitario/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus/aislamiento & purificación , Adulto , Niño , Infecciones Bacterianas del Ojo/microbiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Órbita/diagnóstico por imagen , Seudotumor Orbitario/microbiología , Estudios Retrospectivos , Infecciones Estreptocócicas/microbiología , Síndrome , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
INTRODUCTION: The invasive fungal infection of the maxillary sinus is a rare and serious disease generally favored by immunosuppression. We report an exceptional case of pseudotumoral invasive fungal infection of the maxillary sinus in an immunocompetent patient. OBSERVATION: A 32-year-old patient consulted for labial and left temporal swelling associated with proptosis and chemosis that has been developing for 18 months. The scanner objectified a filling of the left maxillary sinus, and the ipsilateral orbital cavity, and the surrounding muscles. Histological examination of the surgical specimen revealed invasive fungal infection of the left maxillary sinus. The relevant antifungal therapy, namely voriconazole, could not be administered due to the unavailability of the medicine. However, the patient has received 200mg of itraconazole every 12hours for three weeks. The change proved disappointing with recurrence and significant sequelae, sort of sagging of the right hemifacial, severe limitation of mouth opening and functional loss of the right eye. CONCLUSION: The invasive fungus infections of the maxillary sinus and the orbit are exceptional in immunocompetent patient. Healing is based on early diagnosis and administration of the reference antifungal to face the risk of recurrence.
Asunto(s)
Aspergilosis/patología , Sinusitis Maxilar/microbiología , Seudotumor Orbitario/microbiología , Adulto , Antifúngicos/uso terapéutico , Aspergilosis/tratamiento farmacológico , Côte d'Ivoire , Exoftalmia/tratamiento farmacológico , Exoftalmia/microbiología , Exoftalmia/patología , Humanos , Infecciones Fúngicas Invasoras/tratamiento farmacológico , Infecciones Fúngicas Invasoras/microbiología , Infecciones Fúngicas Invasoras/patología , Itraconazol/uso terapéutico , Masculino , Seno Maxilar/microbiología , Seno Maxilar/patología , Sinusitis Maxilar/tratamiento farmacológico , Sinusitis Maxilar/patología , Seudotumor Orbitario/tratamiento farmacológico , Seudotumor Orbitario/patologíaRESUMEN
INTRODUCTION: Pseudo-tumoral fongal rhinosinusitis is a rare and benign illness due to saprophyte germ, Aspergillus flavus. OBSERVATION: We reported two cases of invasive pseudo-tumoral fongal rhinosinusitis. CT scan helped with diagnosis and allowed for extension assessment. Complete surgical excision was done through external approach. Bacteriological examination evidenced the germ. DISCUSSION: Pseudo-tumoral invasive fongal rhinosinusitis remains a potentially serious pathology because of its local aggressiveness and its multiple extensions.
Asunto(s)
Aspergilosis/complicaciones , Seudotumor Orbitario/microbiología , Rinitis/microbiología , Sinusitis/microbiología , Adolescente , Adulto , Aspergilosis/diagnóstico por imagen , Aspergilosis/cirugía , Aspergillus/aislamiento & purificación , Exoftalmia/diagnóstico por imagen , Exoftalmia/microbiología , Exoftalmia/cirugía , Femenino , Humanos , Seudotumor Orbitario/diagnóstico por imagen , Seudotumor Orbitario/cirugía , Radiografía , Rinitis/diagnóstico por imagen , Rinitis/cirugía , Sinusitis/diagnóstico por imagen , Sinusitis/cirugíaAsunto(s)
Aspergillus flavus/fisiología , Neuroaspergilosis/diagnóstico , Seudotumor Orbitario/diagnóstico , Sinusitis/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Neuroaspergilosis/complicaciones , Neuroaspergilosis/microbiología , Seudotumor Orbitario/etiología , Seudotumor Orbitario/microbiología , Sinusitis/etiología , Sinusitis/microbiología , Tomógrafos Computarizados por Rayos XAsunto(s)
Borrelia burgdorferi/aislamiento & purificación , Dacriocistitis/microbiología , Enfermedad de Lyme/microbiología , Seudotumor Orbitario/microbiología , Adulto , Anticuerpos Antibacterianos/sangre , Borrelia burgdorferi/genética , Borrelia burgdorferi/inmunología , ADN Bacteriano/análisis , Dacriocistitis/diagnóstico , Dacriocistitis/tratamiento farmacológico , Doxiciclina/uso terapéutico , Fibrosis , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/tratamiento farmacológico , Masculino , Órbita/patología , Seudotumor Orbitario/diagnóstico , Seudotumor Orbitario/tratamiento farmacológico , Tomografía Computarizada por Rayos XAsunto(s)
Seudotumor Orbitario/microbiología , Faringitis/microbiología , Infecciones Estreptocócicas/microbiología , Antibacterianos/administración & dosificación , Cefotaxima/administración & dosificación , Niño , Femenino , Humanos , Inyecciones Intravenosas , Seudotumor Orbitario/tratamiento farmacológico , Faringitis/tratamiento farmacológico , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus agalactiae/aislamiento & purificaciónRESUMEN
A man with orbital myositis and optic neuritis tested positive serologically for multiple tick-borne diseases. Erlichiosis, babesiosis, and Lyme disease may occur together and affect the eye or orbit.
Asunto(s)
Infecciones Bacterianas del Ojo/microbiología , Neuritis Óptica/microbiología , Seudotumor Orbitario/microbiología , Enfermedades por Picaduras de Garrapatas/microbiología , Animales , Anticuerpos Antibacterianos/análisis , Babesia/inmunología , Babesia/aislamiento & purificación , Borrelia burgdorferi/inmunología , Borrelia burgdorferi/aislamiento & purificación , Diagnóstico Diferencial , Ehrlichia/inmunología , Ehrlichia/aislamiento & purificación , Infecciones Bacterianas del Ojo/diagnóstico , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuritis Óptica/diagnóstico , Seudotumor Orbitario/diagnóstico , Enfermedades por Picaduras de Garrapatas/diagnósticoRESUMEN
OBJECTIVE: To report on the clinical findings in a patient with isolated left inferior rectus myositis associated with serologically confirmed Borrelia burgdorferi infection. DESIGN: Interventional case report. TESTING: Comprehensive clinical, laboratory, and imaging evaluation. RESULTS: Contrast-enhanced computed tomography showed a swollen inferior rectus muscle with infraorbital soft tissue swelling in a patient with diplopia and prior symptoms consistent with manifestations of Lyme disease. Positive serum and cerebrospinal fluid antibodies to B. burgdorferi by enzyme-linked immunoassay were confirmed by Western blot, and the cerebrospinal fluid/serum antibody ratio was elevated. No alternative cause for orbital myositis was found, and treatment with antibiotics resulted in a complete recovery. CONCLUSIONS: Orbital myositis should be added to the expanding list of ophthalmic manifestations of Lyme disease. Correct diagnosis and appropriate antibiotic therapy may reduce the likelihood of further neurologic or ophthalmologic sequelae.