Division of Oral Medicine, Department of Dental Sciences, University of Trieste, Italy.
Head Face Med. 2012 Oct 16;8:28. doi: 10.1186/1746-160X-8-28.
Complications associated to group-A streptococcal pharyingitis include non-suppurative complications such as acute rheumatic fever and glomerulonephritis and suppurative complications such as peritonsillar or retropharyngeal abscess, sinusitis, mastoiditis, otitis media, meningitis, brain abscess, or thrombosis of the intracranial venous sinuses.
We described a case of a 15-year-old patient with a history of acute pharyngodinia early followed by improvise fever and a progressive formation of a diffuse orbital edema, corneal hyperaemia, diplopia and severe decrease of visual acuity.The patient was surgically treated with functional endoscopic sinus surgery (FESS) after the response of a maxillofacial computed tomography scans that showed a pansinusitis complicated by a left orbital cellulites. Numerous colonies of Streptococcus pyogenes were found in the samples of pus and an antibiotic therapy with meropenem was initiated on the basis of the sensitivity test to antibiotics. The patient was finally discharged with diagnosis of left orbital cellulites with periorbital abscess, endophtalmitis and acute pansinusitis as a consequence of streptococcal pharyngitis.
The case highlights the possible unusual complication of a group-A streptococcal pharyingitis in a immunocompetent child and the needing of a prompt surgical and medical approach toward the maxillofacial complications associated to the infection.
A 组链球菌性咽炎相关并发症包括非化脓性并发症，如急性风湿热和肾小球肾炎，以及化脓性并发症，如扁桃体周或咽后脓肿、鼻窦炎、乳突炎、中耳炎、脑膜炎、脑脓肿或颅内静脉窦血栓形成。
我们描述了一例 15 岁患者的病例，该患者有急性咽痛病史，随后出现突发发热，并逐渐形成弥漫性眶周水肿、角膜充血、复视和严重视力下降。患者经颌面计算机断层扫描（CT）检查后，发现全鼻窦炎伴左侧眶蜂窝织炎，行功能性内镜鼻窦手术（FESS）治疗。脓液标本中发现大量化脓性链球菌，根据抗生素敏感性试验，开始使用美罗培南进行抗生素治疗。患者最终被诊断为左侧眶蜂窝织炎伴眶周脓肿、眼内炎和急性全鼻窦炎，这是由链球菌性咽炎引起的。
该病例强调了免疫功能正常的儿童中 A 组链球菌性咽炎可能出现不常见的并发症，以及需要及时进行手术和药物治疗以处理与感染相关的颌面并发症。
