Publication: Case report of orbital cellulitis and necrotizing fasciitis from melioidosis
Issued Date
2013-05-01
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ISSN
15372677
07409303
07409303
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2-s2.0-84880048178
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Mahidol University
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SCOPUS
Bibliographic Citation
Ophthalmic Plastic and Reconstructive Surgery. Vol.29, No.3 (2013)
Suggested Citation
Preamjit Saonanon, Suppapong Tirakunwichcha, Wirongrong Chierakul Case report of orbital cellulitis and necrotizing fasciitis from melioidosis. Ophthalmic Plastic and Reconstructive Surgery. Vol.29, No.3 (2013). doi:10.1097/IOP.0b013e318275b601 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/32356
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Title
Case report of orbital cellulitis and necrotizing fasciitis from melioidosis
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Abstract
A 48-year-old Thai male farmer presented with progressive swelling of the right eyelid and high-grade fever. His visual acuity declined and the right side of his forehead developed a necrotic skin lesion with a purulent discharge. CT of the orbits suggested orbital cellulitis with subperiosteal abscess. Intravenous ceftriaxone and clindamycin were given empirically but then switched to vancomycin and meropenem because of rapid deterioration together with clinical sepsis. Burkholderia pseudomallei was isolated from the blood 3 days after the treatment, and the antibiotics were then switched to intravenous ceftazidime. The liver enzymes were elevated, and imaging of the abdomen revealed liver and splenic abscesses. After 14 days, the patient showed marked clinical improvement, became afebrile, and regained his OD visual acuity. A repeat CT of the orbit showed improvement with no subperiosteal abscess. The antibiotic was then switched to oral trimethoprim/sulfamethoxazole in combination with doxycycline for 6 months. © 2012 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.