Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Ophthalmic Plast Reconstr Surg. 2022;38(1):e19-e23. doi: 10.1097/IOP.0000000000002065.
We present an unusual case of a patient who acquired a pansinusitis and orbital cellulitis with necrotizing features, subsequently developing scleritis, keratitis, and anterior uveitis. To date, there are no reported cases of the simultaneous involvement of these ocular structures from a pansinusitis. Our patient was urgently taken to the operating room for drainage of the abscesses within his sinuses and the orbit. Intraoperative cultures were positive for Parvimonas micra, an odontogenic anaerobic bacteria. He was additionally found to have a central retinal artery occlusion. He was treated with systemic and topical antibiotics as well as topical dilute hypochlorous acid. The mechanisms of virulence of P. micra, including its synergistic relationship with other bacteria, ability to bind plasminogen, and its expression of proteases, contributed to this diffuse infection.
我们报告了一例不常见的病例，患者患有全鼻窦炎和伴有坏死特征的眼眶蜂窝织炎，随后发展为巩膜炎、角膜炎和前葡萄膜炎。迄今为止，尚无报告称全鼻窦炎同时累及这些眼部结构。我们的患者被紧急送往手术室，以引流鼻窦和眼眶内的脓肿。术中培养出微小 Parvimonas，一种牙源性厌氧细菌。他还被发现患有视网膜中央动脉阻塞。他接受了全身和局部抗生素以及局部稀次氯酸治疗。微小 Parvimonas 的毒力机制，包括其与其他细菌的协同关系、结合纤维蛋白溶酶原的能力以及蛋白酶的表达，导致了这种弥漫性感染。
