Arch Craniofac Surg.  2019 Oct;20(5):324-328. 10.7181/acfs.2019.00360.

Delayed intraorbital infection after craniofacial bone surgery

• Jung JS
• Lim NK
• Kang DH

• KMID: 2462488
• DOI: http://doi.org/10.7181/acfs.2019.00360

Abstract

Intraorbital infection shows a low incidence, but it might cause blindness or even death. This case is unusual in that its origin from a craniofacial bone fracture prior to infection of the maxillary sinus. A 33-year-old female patient was referred for right cheek swelling. When she visited the emergency room, we removed right cheek hematoma and bacterial examination was done. In the past, she had craniofacial bone surgical history due to a traffic accident 6 years ago. Next day, the swelling had remained with proptosis and pus was recognized in the conjunctiva. We planned an emergency operation and removed the pus which was already spread inside the orbit. And the evaluation for sinusitis was consulted to the otorhinolaryngology department simultaneously. There were Prevotella oralis and methicillin-resistant Staphylococcus epidermidis bacterial infection in the intraorbital and sinus respectively. Afterwards, the vigorous dressing was done for over a month with intravenous antibiotics. Though the intraorbital infection was resolved, blindness and extraocular movement limitation were inevitable. In conclusion, close follow up of the maxillary sinus in facial bone fracture patients is important and aggressive treatment is needed when an infection is diagnosed.

Keyword

Eye infection; Facial bones; Sinusitis

MeSH Terms

Accidents, Traffic
Adult
Anti-Bacterial Agents
Bacterial Infections
Bandages
Blindness
Cheek
Conjunctiva
Emergencies
Emergency Service, Hospital
Exophthalmos
Eye Infections
Facial Bones
Female
Follow-Up Studies
Fractures, Bone
Hematoma
Humans
Incidence
Maxillary Sinus
Methicillin Resistance
Orbit
Otolaryngology
Prevotella
Sinusitis
Staphylococcus epidermidis
Suppuration
Anti-Bacterial Agents