Vol. 48 No. 2 Case Report PDF

Orbital Subperiosteal Abscess Secondary to Osteomyelitis in a Patient with Chronic Sinusitis

Steffani Krista Someda MD1 , Hendrik Onson MD2 , and Yvette Marie Santiago MD2

1Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan
2Eye Institute, St. Luke’s Medical Center, Quezon City, Philippines

Correspondence: Yvette Marie Santiago
Clinic Address: 1405 N CHBC, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Avenue, Quezon City 1112, Philippines
Clinic Phone Number: +632 8723 0101 ext 5105
Email Address: yvettesantiago@me.com

Disclosure: The authors report no conflict of interest.


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.

Keywords: Orbital osteomyelitis, subperiosteal abscess, chronic sinusitis, surgical complication