Management of bilateral orbital cellulitis in a 41-year-old man

Abstract

Orbital cellulitis is the infl ammation of the tissues of the eye behind the orbital septum. The disease is mainly caused by either bacteria or fungal organisms. Orbital cellulitis is an emergency condition that requires prompt hospitalization and appropriate antibiotic cover without which there will be visual loss and even death! It affects all ages but more common with the younger age groups and males are more prone to the disease. It is a unilateral disease commonly but in rare situations both eyes are affected. We report a case of a bilateral disease in a healthy middle-aged man who presented with fevers, diminished vision, eye pains, lid swellings, severe ptosis, axial proptosis and ophthalmoplegia in both eyes. Our impression was that of Class 5 orbital cellulitis according to Chandler’s classifi cation. His laboratory investigations revealed positive growths of Staphylococcus otherwise his laboratory investigations were all normal. He responded well to intravenous cefuroxime and oral ofl axacin and metronidazole with diclofenac and was discharged from hospital within 1 week. We conclude that prompt hospitalization and appropriate intravenous and oral antibiotics can successfully treat this orbital emergency.

Keywords: Appropriate antibiotics, bilateral orbital cellulitis, bilateral visual loss, orbital septum