Table of Contents

HK J Paediatr (New Series)
Vol 14. No. 4, 2009

HK J Paediatr (New Series) 2009;14:275-278

Case Report

Orbital Cellulitis Complicated by Subperiosteal Abscess in a Neonate with Ethmoiditis
初生嬰兒篩竇炎出現眼眶蜂窩織炎併發骨膜下膿腫

PS Mallika, AK Tan, S Aziz, R Vanitha, TY Tan, HA Faisal


Abstract

Orbital cellulitis is extremely uncommon in neonates. We report a 28 day old baby who presented with sudden onset of fever, red and swollen right eye. The child had symptoms of nasal stuffiness 2 weeks prior to this presentation. Physical and laboratory findings were suggestive of orbital cellulitis. The baby was started on systemic broad spectrum antibiotics. Despite 48 hours of antibiotics, the fever continued and the orbital signs worsened. Computer tomography scan, revealed a subperiosteal abscess along the medial orbital wall associated with ethmoid sinusitis. Surgical drainage of the subperiosteal abscess was followed by resolution of the clinical condition. Majority of children aged 2 and younger respond well to conservative treatment and no surgical intervention is required, but in our case though the causative organism was sensitive to many antibiotics, there was no response to systemic antibiotics. Immediate surgical drainage was followed by rapid resolution of the condition.

初生嬰兒發生眼眶蜂窩織炎非常罕見。我們報告一例病例:一位28日齡嬰兒因為驟然發熱、右眼發紅及腫脹就診,患兒就診前二週出現鼻塞,體查及實驗室檢查提示為眼眶蜂窩織炎,遂給予廣譜抗生素系統性治療。然而,在抗生素治療48小時後,仍持續發熱並且眼眶炎症加重。CT掃描顯示沿眶內側壁出現骨膜下膿腫,併與篩竇炎相關。在給予骨膜下膿腫的外科引流治療後,臨床徵狀消退。大多數2歲以下患兒對保守治療反應良好,而無需手術治療。然而,在我們這個病例中,儘管病原微生物(體外實驗)對多數抗生素敏感,但系統性抗生素治療卻無效。在立即給予外科引流術後,徵狀迅速消退。

Keyword : Complications; Ethmoid sinusitis; Orbital cellulitis; Subperiosteal abscess; Treatment

關鍵詞:併發症、篩竇炎、眼眶蜂窩織炎、骨膜下膿腫、治療

 
 

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