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Year : 2019  |  Volume : 52  |  Issue : 2  |  Page : 60-62

Periorbital purulent drainage of resulting from bacterial pansinusitis

1 Department of Teaching, China Medical University Hospital, Taichung, Taiwan
2 Department of Plastic and Reconstructive Surgery, China Medical University Hospital; China Medical University, Taichung; Department of Cosmetics and Health Care, Chung-Jen Junior College of Nursing, Chiayi, Taiwan

Correspondence Address:
Dr. Pin-Keng Shih
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, 2 Yuh Der Road, 404, Taichung
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_76_18

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Periorbital cellulitis is much more common in younger children than in adolescents or adults, and most cases of uncomplicated periorbital cellulitis can be treated with antibiotics alone. Here, we report a case of a 53-year-old man with periorbital purulent discharge. Computed tomography imaging revealed pansinusitis. Pus culture isolated a pathogen of Streptococcus constellatus, but it was refractory to 2 weeks of antibiotic therapy with amoxicillin–clavulanate. The patient underwent debridement and functional endoscopic sinus surgery, followed by 10 days of hyperbaric oxygen treatment. The above antibiotic was changed to full-dose intravenous clindamycin. Two weeks after the surgery, the patient was discharged from the hospital. At 1-month follow-up, no purulent discharge was noted; however, mild left-eyelid contracture was observed. This study suggested that if conservative therapy for periorbital purulent discharge in an adult is not effective, progressive treatment, including surgery, should be considered.

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