Orbital subperiosteal abscess secondary to osteomyelitis in a patient with chronic sinusitis

ABSTRACT

Objective@#To report a case of orbital subperiosteal abscess in a diabetic elderly patient.@*Methods@#This is a case report.@*Results@#A 65-year-old diabetic female consulted for a two-month history of poor vision on both eyes and a palpable mass on the left brow area. The patient previously underwent functional endoscopic sinus surgery and was treated for postoperative systemic infection and several complications including sinusitis, mastoiditis, trigeminal neuralgia, bacterial meningitis, and otitis media. On presentation, best-corrected visual acuity was noted to be no light perception on the right eye and 20/400 on the left eye. She had a relative afferent pupillary defect on the right eye, ophthalmoplegia on both eyes, and inferior displacement and proptosis of the left globe. Magnetic resonance imaging showed subperiosteal abscess on the left superior orbital rim with intraorbital extension. The patient underwent surgery and the culture from the drained abscess yielded Pseudomonas aeruginosa and Enterobacter cloacae. Pathologic examination of the orbital bone sample revealed osteomyelitis.@*Conclusion@#Osteomyelitis of the orbital bone leading to subperiosteal abscess is a complex, multifactorial disease requiring rapid diagnosis and treatment. Complete resolution of the infection must be achieved to decrease the morbidity and mortality of the patient.