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A case of orbital abscess following porous orbital implant infection.

Hong SW, Paik JS, Kim SY, Yang SW - Korean J Ophthalmol (2006)

Bottom Line: The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket.Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed.A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Purpose: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis.

Methods: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed.

Results: After partial orbital exenteration, the wound finally healed well without any additional abscess formation.

Conclusions: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

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Related in: MedlinePlus

Final follow-up. The wound site was well resolved, and no inflammation or signs of infection were found.
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Figure 6: Final follow-up. The wound site was well resolved, and no inflammation or signs of infection were found.

Mentions: Follow-up magnetic resonance imaging two months after removal of the dermo-fat graft showed inflammatory granulations and abscess formation in the left orbit (Fig. 3). Out of concern that the inflammation might spread to the brain, we performed a partial exenteration of the left orbit. In this procedure, the skin and orbicularis muscle were dissected and removed, and tissue in the orbital apex was taken out of the socket (Fig. 4). Microscopic examination of the exenterated tissue around the abscess revealed massive inflammation, but no bacterial growth was identified in the specimen (Fig. 5). Thereafter, the wound healed well without any additional inflammation. One and one half years after the final surgery, the wound site was well resolved, and no infection or inflammation was found (Fig. 6).


A case of orbital abscess following porous orbital implant infection.

Hong SW, Paik JS, Kim SY, Yang SW - Korean J Ophthalmol (2006)

Final follow-up. The wound site was well resolved, and no inflammation or signs of infection were found.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2908858&req=5

Figure 6: Final follow-up. The wound site was well resolved, and no inflammation or signs of infection were found.
Mentions: Follow-up magnetic resonance imaging two months after removal of the dermo-fat graft showed inflammatory granulations and abscess formation in the left orbit (Fig. 3). Out of concern that the inflammation might spread to the brain, we performed a partial exenteration of the left orbit. In this procedure, the skin and orbicularis muscle were dissected and removed, and tissue in the orbital apex was taken out of the socket (Fig. 4). Microscopic examination of the exenterated tissue around the abscess revealed massive inflammation, but no bacterial growth was identified in the specimen (Fig. 5). Thereafter, the wound healed well without any additional inflammation. One and one half years after the final surgery, the wound site was well resolved, and no infection or inflammation was found (Fig. 6).

Bottom Line: The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket.Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed.A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Purpose: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis.

Methods: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed.

Results: After partial orbital exenteration, the wound finally healed well without any additional abscess formation.

Conclusions: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

Show MeSH
Related in: MedlinePlus