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VOLUME 55 , ISSUE 3 ( July-September, 2021 ) > List of Articles


Orbital Antibioma: A Rare Sequela of Acute Rhinosinusitis

Ramya Rathod, Aditi Mehta, Chirag K Ahuja, Ramandeep Singh Virk

Citation Information :

DOI: 10.5005/jp-journals-10028-1446

License: CC BY-NC 4.0

Published Online: 00-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: To emphasize the infrequent scenarios associated with orbital complications of rhinosinusitis. Background: Orbital sterile collections leading to functional limitation including diplopia can occur in patients with inadequately treated rhinosinusitis and require timely detection followed by definitive management. Case description: We present a case of a previously healthy male with sudden onset left eye proptosis and diplopia of 2 weeks duration referred after endoscopic sinus surgery. Contrast-enhanced magnetic resonance imaging confirmed an organized collection with rim enhancement in the inferior orbit. Endoscopic drainage of the collection along with a microbiological and histopathological examination of the specimen was done. The patient had immediate postoperative alleviation of symptoms. Specimen culture revealed no microbiome growth which was suggestive of a sterile collection or an antibioma. A regular follow-up for a duration of 5 months showed no evidence of residual disease postprocedure and complete recovery. Conclusion: Adequate drainage of the sinuses and orbital abscess with antibiotic coverage during initial surgery with prompt imaging and also ruling out fungal etiology would best treat the orbital complications of acute rhinosinusitis. Clinical significance: Orbital complications of acute rhinosinusitis can be persistent despite treatment and should arise suspicion of residual or recurrent disease. Fungal disease should be ruled out and prompt imaging is helpful in diagnosis. Endonasal endoscopic surgery whenever feasible gives the best results.

  1. Wulc AE. Duane's ophthalmology. Orbital Infections, vol. 2, ch. 34 CD-ROM ed., 1997.
  2. Adulkar NG, Radhakrishnan S, Vidhya N, et al. Invasive sino-orbital fungal infections in immunocompetent patients: a clinico-pathological study. Eye 2019;33(6):988–994. DOI: 10.1038/s41433-019-0358-6.
  3. Garcia GH, Harris GJ. Criteria from nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988–1998. Ophthalmology 2000;107(8):1454–1456. DOI: 10.1016/s0161-6420(00)00242-6, discussion 1457–8.
  4. Fakhri S, Pereira K. Endoscopic management of orbital abscesses. Otolaryngol Clin North Am 2006;39(5):1037–1047. DOI: 10.1016/j.otc.2006.06.001, viii.
  5. Narang S, Khurana MS. Use of antibiotics in pediatric dentistry: not a child's play. Int J Periodontol Implantol 2017;2(4):109–111.
  6. Mahdey H, Muzaffar D, Zafar MS, et al. Facial antibioma formation: a case report. J Oral Res 2018;7(6):250–253. DOI: 10.17126/joralres.2018.055.
  7. Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970;80(9):1414–1428. DOI: 10.1288/00005537-197009000-00007.
  8. Bedwell J, Bauman NM. Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg 2011;19(6):467–473. DOI: 10.1097/MOO.0b013e32834cd54a.
  9. Howells RC, Ramadan HH. Usefulness of computed tomography and magnetic resonance in fulminant invasive fungal rhinosinusitis. Am J Rhinol 2001;15(4):255–261. DOI: 10.1177/194589240101500407.
  10. Aribandi M, McCoy VA, Bazan C. Imaging features of invasive and noninvasive fungal sinusitis. Radiographics 2007;27(5):1283–1296. DOI: 10.1148/rg.275065189.
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