amoxicillin-potassium-clavulanate-combination and Orbital-Diseases

A superior subperiosteal orbital abscess (SSPOA) is a collection of purulent material between the periorbit and the superior bony orbital wall, and is typically a complication of frontal sinusitis. SSPOA is characteristically managed by classic external surgical drainage. The aim of our study was to assess the role of surgical intervention in SSPOA. A retrospective medical chart review of patients diagnosed with SSPOA secondary to rhinosinusitis between the year 2005 and 2013 was conducted. Collected data included age, gender, co-morbidity, clinical presentation, prior antibiotic management, CT scans, surgical approach, outcome and complications. Six patients were included in our study, three males and three females with a mean age of 22.8 (range 9-58). Two patients were treated with amoxicillin clavulanic acid for 3 days prior to admission. Only the youngest patient with the smallest abscess responded successfully to conservative treatment, while the rest were managed surgically: three patients were treated successfully by the endonasal endoscopic approach and two patients were treated by utilizing the combined endonasal endoscopic and external approach. In patients who underwent the combined approach, the abscess was located in a more antero-lateral position than those treated endonasal endoscopically only. The location of a SSPOA dictates the surgical approach. The most antero-lateral SSPOAs should be drained by the combined approach, while more posterior abscesses should be approached endoscopically. Furthermore, a small SSPOA is first to be reported to resolve with conservative treatment. Level 4 (case series).

Topics: Abscess; Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; beta-Lactamase Inhibitors; Child; Drainage; Endoscopy; Female; Humans; Male; Middle Aged; Orbital Diseases; Retrospective Studies; Rhinitis; Sinusitis; Young Adult

To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent.. Single interventional case report.. A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus.. Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks.. Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibodies, Monoclonal; Cefotaxime; Cellulitis; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Infliximab; Male; Microbial Sensitivity Tests; Orbital Diseases; Randomized Controlled Trials as Topic; Spondylitis, Ankylosing; Staphylococcal Infections; Staphylococcus aureus; Tumor Necrosis Factor-alpha

To discuss a rare, but severe complication arising following routine root canal treatment.. An orbital abscess is reported that occurred following routine root canal treatment. A young, healthy female patient, with no history of chronic paranasal infection had undergone root canal treatment of the right maxillary first molar. On hospital admission, she presented with extensive periorbital swelling and discreet diplopia. Computed tomography imaging identified massive purulent sinusitis and subsequent involvement of the orbit via the inferior and medial orbital wall within 48 h after completion of root canal treatment. Immediate surgical drainage of the maxillary sinus and the orbit was established and a high dose of perioperative antibiotics (Amoxicillin/Clavulanic acid, Gentamycin, Metronidazole) were administered. Vision remained undisturbed and mobility of the globe recovered within 10 days.. Rapid exacerbation of a periapical inflammation may occur following root canal treatment and may even involve the orbit. A typical speed of disease progression or ophthalmic symptoms should alert the clinician to at least consider unusual early orbital spread of odontogenic infection. When extra-alveolar spread and especially orbital spread is suspected, immediate referral to a maxillofacial or other specialized unit is mandatory.

Topics: Abscess; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drainage; Drug Combinations; Female; Gentamicins; Humans; Maxilla; Maxillary Sinusitis; Metronidazole; Molar; Orbital Diseases; Periapical Periodontitis; Root Canal Therapy; Tomography, X-Ray Computed

Orbital cellulitis is uncommon. It may arise as a sequel to eyelid infection, or from direct spread of infection from the paranasal sinuses; it may be of odontogenic origin and has been reported after meningitis and after nasoorbital fractures with pre-existing sinusitis. Clinically, orbital cellulitis is of great importance, as it is a severe disease with potentially disastrous consequences. It may lead to optic neuritis, optic atrophy, blindness, cavernous sinus thrombosis, superior orbital fissure syndrome, meningitis, subdural empyema, and even death. We report two cases of severe post-traumatic orbital cellulitis with subperiosteal abscesses. These were managed surgically and vision was preserved. We describe the anatomy, a classification of orbital infection, and the importance of multidisciplinary management of these cases.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Cellulitis; Decompression, Surgical; Drainage; Drug Therapy, Combination; Humans; Injections, Intravenous; Male; Orbit; Orbital Diseases; Skull Fractures

Odontogenic infections may spread to the orbit by one or more of several paths. Such extension is potentially dangerous and may lead to loss of vision. A case of infection from a primary tooth, which extended to the retrobulbar area is presented in this report. Treatment included surgical drainage of the resulting subperiosteal orbital abscess through a Caldwell-Luc approach as well as aggressive antibiotic therapy. The importance of early suspicion of this entity and its potential sequelae are discussed.

Topics: Amoxicillin-Potassium Clavulanate Combination; Child, Preschool; Dental Caries; Drainage; Drug Therapy, Combination; Eye Infections, Bacterial; Focal Infection, Dental; Humans; Male; Maxilla; Molar; Orbital Diseases; Tooth, Deciduous

The exact incidence of orbital complications due to sinusitis in children is unknown. However, a medial subperiosteal orbital abscess is the most common serious complication to occur. Surgical intervention is mandatory whenever antibiotic treatment fails. Most authors prefer open surgical procedures such as external ethmoidectomy, while others recommend transnasal endoscopic drainage as the first attempt at sinus decompression. Five out of 12 children with proven subperiosteal orbital abscess and sinusitis on computed tomographic scans failed antibiotic treatment and required surgical drainage. Transnasal endoscopic drainage of the abscess was performed on four patients, while one child underwent external ethmoidectomy. Our experience with endoscopic surgery in these four cases is discussed, along with a brief review of the advantage of this procedure over external surgery.

Topics: Abscess; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefuroxime; Cephalosporins; Child; Child, Preschool; Drainage; Drug Therapy, Combination; Endoscopy; Ethmoid Bone; Ethmoid Sinusitis; Female; Frontal Sinusitis; Humans; Male; Maxillary Sinusitis; Nose; Orbital Diseases; Periosteum; Sinusitis; Tomography, X-Ray Computed; Treatment Failure