J Korean Ophthalmol Soc.  2011 Jun;52(6):647-652. 10.3341/jkos.2011.52.6.647.

Effects of Additional Prednisolone Treatment in Orbital Cellulitis after Bougination

• Ryu WY
• Park JK
• Ahn HB

• KMID: 2214634
• DOI: http://doi.org/10.3341/jkos.2011.52.6.647

Abstract

PURPOSE
To investigate the effects of additional prednisolone treatments in orbital cellulitis after bougination.
METHODS
The medical records of five patients treated for orbital cellulitis after bougination were reviewed. The number of times bouginated, clinical symptoms, biopsy findings, treatment course, recurrence, and prognosis were reviewed.
RESULTS
A diffuse, erythematous mass on the lower lid around the medial canthal area was found in all patients. Bougination was performed more than twice in three patients. Chronic inflammation was checked via pathologic tissue biopsy examination in four patients. No patients receiving antibiotic treatments improved, thus additional prednisolone was used and showed satisfactory results, although recurrence was observed in two patients. The recurred two patients improved with repetitive prednisolone treatments.
CONCLUSIONS
Although antibiotics are administered for the treatment of orbital cellulitis after bougination, the use of additional corticosteroids may be beneficial when inflammation is sustained.

Keyword

Bougination; Orbital cellulitis

MeSH Terms

Adrenal Cortex Hormones
Anti-Bacterial Agents
Biopsy
Humans
Inflammation
Medical Records
Orbit
Orbital Cellulitis
Prednisolone
Prognosis
Recurrence
Adrenal Cortex Hormones
Anti-Bacterial Agents
Prednisolone

Figure

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  Figure 1. (A) Photograph of a 54-year-old woman with marked diffuse and erythematous lid swelling of the left eye on admission (case 1). (B) Photograph of a 66-year-old woman with marked diffuse and erythematous lid swelling with a pustule of the right eye on admission (case 2). All Orbital CT scans show a diffuse inferomedial orbital inflammation or mass.

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  Figure 2. (A, B) Neutrophils and lymphocytes are increased and stromal fibrosis are founded (hematoxylin-eosin) (case 4), A (×40), B (×200). (C, D) Lymphocytes and spindle cells of fibroblastic/myofibroblastic appearance permeate the adipose tissue (hematoxylin-eosin) (case 5), C (×40), D (×200).

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  Figure 3. (A) Photograph of a 54-year-old woman with marked diffuse and erythematous lid swelling of the left eye despite additional antibiotics therapy (case 1). (B) Photograph of a 66-year-old woman with marked diffuse and erythematous lid swelling with pustule of the right eye despite additional antibiotics therapy (case 2).

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  Figure 4. (A) Photograph of a 54-year-old woman with improvement of marked diffuse and erythematous lid swelling of the left eye after additional steroid therapy (case 1). (B) Photograph of a 66-year-old woman with improvement of marked diffuse and erythematous lid swelling with pustule of the right eye after additional steroid therapy and surgical drainage (case 2).

Reference

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