A rare case of Enterococcus faecalis-induced orbital cellulitis and myositis.

Orbital cellulitis is an infection of soft tissue behind the orbital septum. Common pathogens isolated include Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae. It is a straightforward diagnosis and usually responds to empirical treatment without any sequela. We report a case of orbital cellulitis caused by Enterococcus faecalis, which was complicated by myositis of levator palpebrae superioris. To the best of our knowledge, only one case report exists dating way back to 1986.

Miositis orbitaria como complicación tras una amigdalitis por «Streptococcus pyogenes» / Orbital myositis as a complication of Streptococcus pyogenes amigdalitis

La miositis orbitaria es un trastorno inflamatorio poco común en la infancia, clasificado dentro del llamado síndrome inflamatorio de la órbita, o seudotumor orbitario, en el que se ven afectados los músculos extraoculares. Presentamos el caso de un paciente de 12 años de edad, con dolor y edema palpebral de inicio brusco, junto con limitación de la movilidad ocular. Tras la realización de pruebas de imagen y estudios de laboratorio, se diagnostica de miositis orbitaria tras una infección estreptocócica. Aun siendo una asociación poco frecuente, debemos tener en cuenta esta etiología infecciosa ante un paciente con clínica de dolor ocular brusco y limitación de la movilidad, sobre todo en casos con antecedentes de infección de las vías respiratorias altas(AU)

Orbital myositis is an uncommon inflammatory disorder in childhood, classified into orbital inflammation syndrome, or orbital pseudotumor, where extraocular muscles are affected. We report a 12 years old patient with pain, eyeld oedema and ocular motility limitation. After the scan and laboratories exam he was diagnosed of orbital myositis after streptococcal infection. Even as a rare association we should take account of this infectious etiology in a patient with symptoms of sudden eye pain and limited mobility, especially in cases with a recent history of upper respiratory tract infection(AU)

Orbital myositis: diagnosis and management.

Orbital myositis is an inflammatory process that primarily involves the extraocular muscles and most commonly affects young adults in the third decade of life, with a female predilection. Clinical characteristics of orbital myositis include orbital and periorbital pain, ocular movement impairment, diplopia, proptosis, swollen eyelids, and conjunctival hyperemia. The most common presentation is acute and unilateral, which initially responds to systemic corticosteroid therapy. However, chronic and recurrent cases may involve both orbits. Many inflammatory, vascular, neoplastic, and infectious conditions that affect the extraocular muscles and other orbital tissue can mimic orbital myositis. The most important differential diagnoses include thyroid-related eye disease, other orbital inflammatory processes (unspecific idiopathic inflammation, vasculitis, and sarcoidosis), orbital cellulitis, and orbital tumors. In refractory, chronic, or recurrent cases, steroid-sparing agents, inmmunosuppressants, or radiation therapy may be indicated.