FP260 : Unusual case of bilateral preseptal and orbital cellulitis in an infant

Dr.SARITA BERI, B06053

A 2.5 month old female presented with inability to open her right eye due to marked swelling and redness of both upper and lower lids. Left lower lid was also showing similar features. It was associated with fever, purulent discharge and mild abduction limitation in both eyes (BE). There was no proptosis and pupils and fundus were normal. Diagnosis of preseptal cellulitis was made. MRI demonstrated BE orbital cellulitis with right ethmoidal sinusitis. Patient did not respond to systemic antibiotics and underwent bilateral uncinectomy and right ethmoidal decompression under general anesthesia by ENT team and pus obtained revealed a mixed infection with E.coli and Methicillin Resistant Staphylococcus aureus. Transconjunctival incision & drainage of pus was done from left eye two days later. Patient demonstrated marked clinical improvement. Bilateral orbital cellulitis is an uncommon presentation. Multidisciplinary management approach can avert potentially life threatening sequelae.