Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Ocul Immunol Inflamm. 2023 Sep;31(7):1555-1558. doi: 10.1080/09273948.2022.2134897. Epub 2022 Oct 26.
We present a case of a 7-year-old boy who was presented with a small medial subperiosteal orbital abscess (SPOA) and trace superior phlegmon and who was initially treated with intravenous (IV) antibiotics, corticosteroids, and observation. After clinical resolution and discharge, the patient returned with superior migration of his abscess requiring surgical drainage. Potential factors leading to readmission are discussed, including the anti-inflammatory and immunosuppressant effects of steroids, and presence of early surgical indictors such as bony dehiscence and proptosis. This case highlights the need for careful consideration of initial imaging and presence of a non-medial phlegmon prior to initiation of steroids.
我们报告了一例 7 岁男孩，他患有小的内侧骨膜下眶脓肿（SPOA）和微量的上咽旁蜂窝组织炎，最初接受了静脉（IV）抗生素、皮质类固醇和观察治疗。临床缓解和出院后，患者的脓肿向上迁移，需要手术引流。讨论了导致再次入院的潜在因素，包括类固醇的抗炎和免疫抑制作用，以及早期手术指标的存在，如骨裂开和突出。这个病例强调了在开始使用类固醇之前，仔细考虑初始影像学检查和是否存在非内侧咽旁蜂窝组织炎的重要性。
