Orbital Cellulitis Following Orbital Blow-out Fracture

Abstract

Orbital cellulitis and abscess have been described in the literature as complication that usually occur secondary to infection in the maxillary, ethmoidal, and frontal sinuses. If left untreated, it can lead to blindness, cavernous sinus thrombosis, meningitis, or cerebral abscess. Orbital fractures are a common sequela of blunt orbital trauma, but are only rarely associated with orbital cellulitis. So, the authors present rare orbital cellulitis after orbital blow-out fracture. A 55-year-old Asian complains of severe orbital swelling and pain on the left side. These symptoms had started 2 days earlier and worsened within the 24 hours before hospital admission resulting in visual disturbances such as diplopia and photophobia. Contrast-enhanced computed tomography scan showed considerable soft tissue swelling and abscess formation on the left side. Patient was subjected to surgical drainage under general anesthesia in the operation room. In this case, the postoperative period was uneventful and the rapid improvement of symptoms was remarkable. In conclusion, the abscess of the orbit is a surgical emergency in patients whose impairment of vision or ocular symptoms cannot be controlled with medical therapy using antibiotics. In our case, orbital cellulitis can occur after blunt orbital trauma without predisposing sinusitis. Early and prompt diagnosis and surgical drainage before severe loss of visual acuity rescue or recover the vision in case of orbital cellulitis.