CASE REPORT   

Chirurgia 2020 October;33(5):255-9

DOI: 10.23736/S0394-9508.19.05000-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

A rare case of blindness due to an odontogenic abscess

Paola BONAVOLONTÀ ¹ ✉, Giovanni DELL’AVERSANA ORABONA ¹, Francesco SEIDITA ¹, Piero DONNA ², Umberto COMMITTERI ¹, Vincenzo ABBATE ¹, Luca D’ANDREA ², Luigi CALIFANO ¹

¹ Unit of Maxillofacial Surgery, ENT Department, Federico II University, Naples, Italy; ² Unit of Ophthalmology, ENT Department, Federico II University, Naples, Italy

Orbital cellulitis can be caused by distant infective foci, local spread and surgical procedures. Typical symptoms and signs are conjunctival chemosis, pain, extraocular muscles dysfunction, proptosis and visual impairment; systemic symptoms are fever and general discomfort. Nowadays death is uncommon, due to prompt antimicrobial and surgical management, but loss of vision remains an important cause of morbidity. This article shows the case of a 50-years-old woman referred to the Department of Orbital Pathology of the Hospital Polyclinic Federico II (Naples) with a severe case of odontogenic orbital cellulitis. The orbital infection caused bulbar perforation and endophthalmitis. An evisceration surgery was indicated to avoid a risky sympathetic endophthalmitis. Surgical and medical prompt therapy lead to clinical improvement. Odontogenic orbital cellulitis is a rare, serious infection which can lead to endophthalmitis and visual loss. Unfortunately, the dental origin of infection can be missed during the examination. For these reasons, it’s important for the practitioner to consider this source or infection. The management consists of prompt medical therapy, intensive monitoring, cultural exams, serial imaging and proper surgical intervention, if needed. Therefore, early hospitalization and multidisciplinary approach are mandatory.

KEY WORDS: Cellulitis; Abscess; Blindness