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KMID : 1030220160170030219
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Journal of Korean Diabetes
2016 Volume.17 No. 3 p.219 ~ p.223
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A Case of Actinomycosis of an Orbital Subperiosteal Abscess in a Patient with Type 2 Diabetes Mellitus
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Park Jong-Eun
Kang Jae-Bin
Park Hyun-Young
Ahn Ji-Yeon
Shin Jae-Ho
Lee Kun-Hee
Cho In-Jin
Hwang You-Chul
Ahn Kyu-Jeung
Chung Ho-Yeon
Jeong In-Kyung
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Abstract
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Orbital and paranasal actinomycosis have not been commonly reported. We report a case of this uncommon infection, which was improved after endonasal endoscopic drainage and antibiotics. A 53-year-old woman with type 2 diabetes mellitus complained of inability to lift her right upper eyelid and painful swelling over the preceding two days. Broad-spectrum antibiotics did not resolve her lesion. In ophthalmic examination, decreased visual acuity, upper and medial gaze limitation, and a relative afferent pupillary defect of her right eye were observed. Computed tomography of the orbit showed aggravated orbital cellulitis, preseptal cellulitis, subperiosteal abscess, and maxillary and ethmoid sinusitis. After endonasal endoscopic drainage and systemic antibiotics, her clinical symptoms dramatically improved. Microbiological analysis of the maxillary excisional biopsy showed Actinomycosis. This case is of interest due to the rare orbital presentation of actinomycosis infection and the importance of appropriate surgical drainage and long-term antibiotics treatment in such cases. Because delayed diagnosis and treatment of rhino-orbital actinomycosis can cause permanent vision loss or intracranial abscess, it requires careful clinical attention.
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KEYWORD
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Actinomycosis, Orbital cellulitis, Type 2 diabetes mellitus
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