A Case of Chronic Osteomyelitis of the Orbit

ABSTRACT

PURPOSE: To report a case of chronic osteomyelitis of the orbit. CASE SUMMARY: A 61-year-old woman visited the ophthalmology clinic with a 3-month history of right periorbital swelling and pain. She had a history of ondontitis treated with oral antibiotics three months previously. A hard, tender, swollen mass was palpated near the right lower eyelid extending to the floor of the right orbit. Otherwise, there were no other clinically-specific ocular signs. Orbital computed tomography and bone scan findings suggested right periorbital soft tissue inflammation with underlying osteomyelitis of maxillar and zygomatic bones involving the inferior and lateral orbital walls. The patient was admitted and treated with broad spectrum systemic antibiotics. After 7 days, periorbital soft tissue swelling and pain were improved, but the size of the hard mass was unchanged. Seven days after admission, incision and drainage of the periorbital hard mass near the lower eyelid and debridement of the necrotic and pyogenic tissue were performed. Histologic examination showed chronic granulomatous inflammation and bony necrosis of the mass. The patient was discharged after receiving systemic antibiotics for 7 more days. At the 6-month follow-up, no recurrence or abnormal findings in the right periorbital region were observed. CONCLUSIONS: Chronic orbital osteomyelitis should be treated with combined systemic antibiotics and surgical intervention.