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Life-Threatening Infections

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Emergencies of the Orbit and Adnexa

Abstract

There are very few potentially fatal clinical conditions that present primarily to the ophthalmologist. Majority of these conditions are infective in nature and may have an acute, subacute, or even a chronic course. Three such conditions, cavernous sinus thrombosis, periocular necrotizing fasciitis, and invasive fungal sinusitis, have been reviewed in this chapter. This chapter aims to cover the clinical features, diagnosis, and management of these three clinical entities.

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References

  1. Berdai AM, et al. Cavernous sinus thrombophlebitis complicating sinusitis. Am J Case Rep. 2013;14:99–102.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Verma R, Junewar V, Singh RK, Ram H, Pal US. Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess. Natl J Maxillofac Surg. 2013;4:252–5.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kiddee W, Preechawai P, Hirunpat S. Bilateral septic cavernous sinus thrombosis following the masticator and parapharyngeal space infection from the odontogenic origin: a case report. J Med Assoc Thai. 2010;93:1107–11.

    PubMed  Google Scholar 

  4. DiNubile MJ. Septic thrombosis of the cavernous sinuses. Arch Neurol. 1988;45(5):567–72.

    Article  CAS  PubMed  Google Scholar 

  5. Feldman DP, Picerno NA, Porubsky ES. Cavernous sinus thrombosis complicating odontogenic parapharyngeal space neck abscess: a case report and discussion. Otolaryngol Head Neck Surg. 2000;123:744–5.

    Article  CAS  PubMed  Google Scholar 

  6. Piazza G. Cerebral venous thrombosis. Circulation. 2012;125(13):1704–9.

    Article  PubMed  Google Scholar 

  7. Swaminath D, Narayanan R, Orellana-Barrios MA, Temple B. Necrotizing fasciitis of the nose complicated with cavernous sinus thrombosis. Case Rep Infect Dis. 2014;2014:914042.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Clarke M, Enuh H, Saverimuttu J, Nfonoyim J. Streptococcus group C meningitis with cavernous sinus thrombosis. Infect Drug Resist. 2013;6:79–81.

    PubMed  PubMed Central  Google Scholar 

  9. Ebright JR, Pace MT, Niazi AF. Septic thrombosis of the cavernous sinuses. Arch Intern Med. 2001;161:2671–6.

    Article  CAS  PubMed  Google Scholar 

  10. Saposnik G, Barinagarrementeria F, Brown Jr RD, Bushnell CD, Cucchiara B, Cushman M, de Veber G, Ferro JM, Tsai FY, American Heart Association Stroke Council, Council on Epidemiology and Prevention. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(4):1158–92.

    Article  PubMed  Google Scholar 

  11. Yarington Jr CT. Cavernous sinus thrombosis revisited. Proc R Soc Med. 1977;70:456–9.

    PubMed  PubMed Central  Google Scholar 

  12. Mehta R, Kumar A, Crock C, McNab A. Medical management of periorbital necrotising fasciitis. Orbit. 2013;32(4):253–5.

    Article  PubMed  Google Scholar 

  13. Amrith S, HosdurgaPai V, Ling WW. Periorbital necrotizing fasciitis – a review. Acta Ophthalmol. 2013;91(7):596–603.

    Article  PubMed  Google Scholar 

  14. Prendiville KJ, Bath PE. Lateral cantholysis and eyelid necrosis secondary to Pseudomonas aeruginosa. Ann Ophthalmol. 1988;20(5):193–5.

    CAS  PubMed  Google Scholar 

  15. Scheepers MA, Keel S, Michaelides M. Bilateral necrotising fasciitis of the ocular adnexa secondary to Pseudomonas aeruginosa septicaemia in a HIV-positive child. Orbit. 2010;29(1):63–4.

    Article  PubMed  Google Scholar 

  16. Lazzeri D, Lazzeri S, Figus M, Tascini C, Bocci G, Colizzi L, Giannotti G, Lorenzetti F, Gandini D, Danesi R, Menichetti F, Del Tacca M, Nardi M, Pantaloni M. Periorbital necrotising fasciitis. Br J Ophthalmol. 2010;94(12):1577–85.

    Article  PubMed  Google Scholar 

  17. Bilyk JR. Periocular infection. Curr Opin Ophthalmol. 2007;18(5):414–23.

    Article  PubMed  Google Scholar 

  18. Luksich JA, Holds JB, Hartstein ME. Conservative management of necrotising fasciitis of the eyelids. Ophthalmology. 2002;109(11):2118–22.

    Article  PubMed  Google Scholar 

  19. Elner VM, Demirci H, Nerad JA, Hassan AS. Periocular necrotizing fasciitis with visual loss pathogenesis and treatment. Ophthalmology. 2006;113(12):2338–45.

    Article  PubMed  Google Scholar 

  20. Kronish JW, McLeish WM. Eyelid necrosis and periorbital necrotizing fasciitis. Report of a case and review of the literature. Ophthalmology. 1991;98(1):92–8.

    Article  CAS  PubMed  Google Scholar 

  21. Akamine M, Miyagi K, Uchihara T, Azuma M, Yara S, Higa F, Haranaga S, Tateyama M, Matsuzaki A, Nakayama T, Fujita J. Necrotizing fasciitis caused by Pseudomonas aeruginosa. Intern Med. 2008;47(6):553–6.

    Article  PubMed  Google Scholar 

  22. Stone L, Codere F, Ma SA. Streptococcal lid necrosis in previously healthy children. Can J Ophthalmol. 1991;26(7):386–90.

    CAS  PubMed  Google Scholar 

  23. Henrich DE, Smith TL, Shockley WW. Fatal craniocervical necrotizing fasciitis in an immuno competent patient: a case report and review of the literature. Head Neck. 1995;17(4):351–7.

    Article  CAS  PubMed  Google Scholar 

  24. Committee on Infectious Diseases, American Academy of Pediatrics. Severe invasive group A streptococcal infections: a subject review. Pediatrics. 1998;101:136–40.

    Article  Google Scholar 

  25. Carlisle RT, Fredrick GT. Preseptal and orbital cellulitis. Hosp Physician. 2006;42:15–9.

    Google Scholar 

  26. Brown DR, Davis NL, Lepawsky M, Cunningham J, Kortbeek J. A multicenter review of the treatment of major truncal necrotizing infections with and without hyperbaric oxygen therapy. Am J Surg. 1994;167:485–9.

    Article  CAS  PubMed  Google Scholar 

  27. Beerens AJ, Bauwens LJ, Leemans CR. A fatal case of craniofacial necrotising fasciitis. Eur Arch Otorhinolaryngol. 1999;256(10):506–9.

    Article  CAS  PubMed  Google Scholar 

  28. Steinkogler FJ, Huber-Spitzy V. Necrotising destruction of the ocular adnexa by Pseudomonas aeruginosa. J Craniomaxillofac Surg. 1988;16(1):28–30.

    Article  CAS  PubMed  Google Scholar 

  29. Doorenbos-Bot AC, Hooymans JM, Blanksma LJ. Periorbital necrotising fasciitis due to Cryptococcus neoformans in a healthy young man. Doc Ophthalmol. 1990;75:315–20.

    Article  CAS  PubMed  Google Scholar 

  30. Shindo ML, Nalbone VP, Dougherty WR. Necrotizing fasciitis of the face. Laryngoscope. 1997;107:1071–9.

    Article  CAS  PubMed  Google Scholar 

  31. Thurtell MJ, Chiu AL, Goold LA, Akdal G, Crompton JL, Ahmed R, Madge SN, Selva D, Francis I, Ghabrial R, Ananda A, Gibson J, Chan R, Thompson EO, Rodriguez M, McCluskey PJ, Halmagyi GM. Neuro-ophthalmology of invasive fungal sinusitis: 14 consecutive patients and a review of the literature. Clin Experiment Ophthalmol. 2013;41(6):567–76.

    Article  PubMed  Google Scholar 

  32. Epstein VA, Kern RC. Invasive fungal sinusitis and complications of rhinosinusitis. Otolaryngol Clin N Am. 2008;41:497–524.

    Article  Google Scholar 

  33. Chakrabarti A, Das A, Panda NK. Controversies surrounding the categorization of fungal sinusitis. Med Mycol. 2009;47 Suppl 1:S299–308.

    Article  PubMed  Google Scholar 

  34. Arndt S, Aschendorff A, Echternach M, Daemmrich TD, Maier W. Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment. Eur Arch Otorhinolaryngol. 2009;266:71–6.

    Article  PubMed  Google Scholar 

  35. Johnson TE. Fungal disease of the orbit. Ophthalmol Clin N Am. 2000;13:643–56.

    Article  Google Scholar 

  36. Yohai R, Bullock J, Aziz A, Markert RJ. Survival factors in rhino-orbital-cerebral mucormycosis. Surv Ophthalmol. 1994;39(1):3–22.

    Article  CAS  PubMed  Google Scholar 

  37. Lee AG, Brazis PW. Systemic infections of neuro-ophthalmic significance. OphthalmolClin North Am. 2004;17(3):397–425.

    Article  Google Scholar 

  38. Pushker N, Meel R, Kashyap S, Bajaj MS, Sen S. Invasive aspergillosis of orbit in immunocompetent patients: treatment and outcome. Ophthalmology. 2011;118(9):1886–91.

    Article  PubMed  Google Scholar 

  39. Decanini-Mancera A, Lessell S, Lee MS, Subramanian PS. Syphilis and the monk. Surv Ophthalmol. 2011;56(3):267–73.

    Article  PubMed  Google Scholar 

  40. Clancy CJ, Nguyen MH. Invasive sinus aspergillosis in apparently immunocompetent hosts. J Infect. 1998;37:229–40.

    Article  CAS  PubMed  Google Scholar 

  41. Green WR, Font RL, Zimmerman LE. Aspergillus of the orbit. Arch Ophthalmol. 1969;82:302–13.

    Article  CAS  PubMed  Google Scholar 

  42. Levin LA, Avery R, Shore JW, et al. The spectrum of orbital aspergillosis: a clinicopathological review. Surv Ophthalmol. 1996;41:142–54.

    Article  CAS  PubMed  Google Scholar 

  43. Mody KH, Ali MJ, Vemuganti GK, Nalamada S, Naik MN, Honavar SG. Orbital aspergillosis in immunocompetent patients. Br J Ophthalmol. 2014;98(10):1379–84.

    Article  PubMed  Google Scholar 

  44. Wali U, Balkhair A, Al-Mujaini A. Cerebro-rhino orbital mucormycosis: an update. J Infect Public Health. 2012;5(2):116–26.

    Article  PubMed  Google Scholar 

  45. Eucker J, Sezer O, Graf B, Possinger K. Mucormycosis. Mycoses. 2001;44:253–60.

    Article  CAS  PubMed  Google Scholar 

  46. Vagefi MR, Kim ET, Alvarado RG, Duncan JL, Howes EL, Crawford JB. Bilateral endogenous Scedosporium prolificans endophthalmitis after lung transplantation. Am J Ophthalmol. 2005;139:370–3.

    Article  PubMed  Google Scholar 

  47. Rodriguez-Tudela JL, Berenguer J, Guarro J, et al. Epidemiology and outcome of Scedosporium prolificans infection, a review of 162 cases. Med Mycol. 2009;47:359–70.

    Article  PubMed  Google Scholar 

  48. Dinowitz M, Leen JS, Hameed M, Wolansky L, Frohman L. Sudden painless visual loss. Surv Ophthalmol. 2001;46(2):143–8.

    Article  CAS  PubMed  Google Scholar 

  49. McNab AA. Invasive fungal sinusitis: ophthalmic emergency. Clin Experiment Ophthalmol. 2013;41(6):521.

    Article  PubMed  Google Scholar 

  50. Fairley C, Sullivan TJ, Bartley P, Allworth T, Lewandowski R. Survival after rhino-orbital-cerebral mucormycosis in an immunocompetent patient. Ophthalmology. 2000;107(3):555–8.

    Article  CAS  PubMed  Google Scholar 

  51. Sivak-Callcott JA, Livesley N, Nugent RA, et al. Localized invasive sino-orbital aspergillosis: characteristic features. Br J Ophthalmol. 2004;88:681–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Stevens DA, Kan VL, Judson MA. Practice guidelines for disease caused by aspergillus. Clin Infect Dis. 2000;30:696–709.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Milind N. Naik MD .

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Nair, A.G., Naik, M.N. (2017). Life-Threatening Infections. In: Mukherjee, B., Yuen, H. (eds) Emergencies of the Orbit and Adnexa. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1807-4_35

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  • DOI: https://doi.org/10.1007/978-81-322-1807-4_35

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