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Case Reports
. 2012:6:1429-32.
doi: 10.2147/OPTH.S27034. Epub 2012 Sep 4.

Bilateral intraorbital abscesses with intracranial complications in a young Cameroonian girl: a case report

Oumarou Abdouramani  1 , S Nguefack, Va Dohvoma, B Moifo, André Omgbwa Eballé, A Moho, E Epee, E Mbonda, Al Bella
Affiliations
Case Reports

Bilateral intraorbital abscesses with intracranial complications in a young Cameroonian girl: a case report

Oumarou Abdouramani et al. Clin Ophthalmol. 2012.

Abstract

Background: Intraorbital abscess is a very severe infection with ophthalmologic and neurologic complications that are sometimes life-threatening.

Objective: To report the etiologic, clinical, radiologic, and prognostic features of one case of bilateral intraorbital abscesses with intracranial complications.

Case report: A 15-year-old Cameroonian girl in a comatose state (11/15 on the Glasgow Coma Scale) with meningeal signs, right hemiplegia, right facial palsy, and bilateral exophthalmia was admitted for meningitis and cerebral abscess secondary to orbital cellulitis. A lumbar tap was carried out, no organisms were seen by Gram stain, and culture was negative due to previous antibiotic therapy. A computed tomography scan showed a left internal capsule infarct and a pansinus opacification. Bilateral superior orbitotomies were performed and the abscess evacuated. Microscopy and culture of surgical material were negative. The patient was discharged 4 weeks after hospital admission with a visual acuity of 0.1 in both eyes, aphasia, and right hemiplegia. Nine months later, there was complete visual recovery (visual acuity 1.0 in both eyes). Anterior and posterior segments were normal on slit-lamp examination. There was no aphasia, but right-sided hemiparesis persisted.

Conclusion: The authors emphasize the need for prevention, early diagnosis, and adequate treatment of orbital cellulitis in order to avoid complications.

Keywords: hemiparesis; intracranial complications; intraorbital abscess; orbital cellulitis; orbitotomies; pansinusitis.

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Figures

Figure 1
Figure 1
Photograph of patient following orbitotomies. Note bilateral exophthalmia, bilateral chemosis and bilateral eyelid oedema. The two arrows are pointing at the two orbitotomies.
Figure 2
Figure 2
(A) Frontal sinusitis, (B) maxillary sinusitis, and (C) bilateral intraorbital abscesses.
Figure 3
Figure 3
Left internal capsule infarct.
See this image and copyright information in PMC

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