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Poignet B, Landman-Vu J, Bouayed E, Brézin A. Orbital abscess following sub-Tenon's corticosteroid injection: A rare but severe complication. J Fr Ophtalmol 2024; 47:104147. [PMID: 38493560 DOI: 10.1016/j.jfo.2024.104147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/12/2024] [Indexed: 03/19/2024]
Affiliation(s)
- B Poignet
- Department of Ophthalmology, Sorbonne Université, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Institut Œil, Paupière et Rétine, 92, rue Saint-Lazare, 75009 Paris, France.
| | - J Landman-Vu
- Institut Œil, Paupière et Rétine, 92, rue Saint-Lazare, 75009 Paris, France; Department of Ophthalmology, Hôpital Cochin, Université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - E Bouayed
- Department of Ophthalmology, Hôpital Cochin, Université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - A Brézin
- Department of Ophthalmology, Hôpital Cochin, Université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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2
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IRIE M, KITA C, YAMAGAMI T, MIYOSHI T, FUJIKI N, KURIYAGAWA Y, HANAFUSA Y, CHAMBERS JK, UCHIDA K. A case of Exophiala dermatitidis-induced phaeohyphomycosis in a cat with multiple intra-abdominal masses. J Vet Med Sci 2024; 86:550-554. [PMID: 38631889 PMCID: PMC11144537 DOI: 10.1292/jvms.23-0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
Pus discharge containing black granular materials (1-2 mm in diameter) was found in the abdominal skin of a 13-year-old sterilized female cat. Abdominal ultrasonography revealed a large intra-abdominal mass with abundant blood flow beneath the skin lesion. Laparotomy revealed a large mass that adhered to the spleen and left kidney. Similar small lesions were found in the abdominal wall and mesentery. The masses were surgically removed along with the spleen and kidney. Histopathologically, the mass lesions consisted of granulomas with lesional pigmented fungi, and the cat was diagnosed with phaeohyphomycosis. Uisng genetic analysis, the Exophiala dermatitidis was identified as the causative pathogen.
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Affiliation(s)
| | - Chiaki KITA
- Shikoku Cytopathological Laboratory, Kagawa, Japan
| | | | | | | | | | - Yasuko HANAFUSA
- Enteric Pathogen Group, Division of Zoonosis Research, National Institute of Animal Health, National Agriculture and Food Research Organization, Ibaraki, Japan
| | - James Kenn CHAMBERS
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki UCHIDA
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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3
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Gupta I, Moussa E, Motupally K, Morris S. Diagnosis of an unusual orbital abscess following sub-Tenon's steroid injection: a case report. J Surg Case Rep 2024; 2024:rjae339. [PMID: 38817784 PMCID: PMC11138107 DOI: 10.1093/jscr/rjae339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024] Open
Abstract
Orbital abscesses are caused by infection within or near the orbit and show obvious signs of pain, proptosis and raised inflammatory markers. Diagnosis is based on clinical features and radiological imaging, and requires early antibiotics and often surgical drainage to save vision. Sub-Tenon's injections of triamcinolone acetonide (TA) have caused localized infections in previous reports, which have responded to therapeutic interventions. Here we report a case where a delayed presentation of an orbital abscess secondary to sub-Tenon's TA for persistent post-operative cystoid macular oedema, without obvious signs of infection, rapidly progressed to cause orbital compartment syndrome. Despite treatment, the patient lost complete vision in the affected eye. This case discusses the rare and unusual cause of abscess formation and a diagnostic dilemma.
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Affiliation(s)
- Isha Gupta
- Department of Ophthalmology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia
| | - Elliott Moussa
- Department of Ophthalmology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia
| | - Karun Motupally
- Department of Radiology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia
| | - Sharon Morris
- Department of Ophthalmology, Gold Coast University Hospital, Hospital Blvd, Southport 4215, Queensland, Australia
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4
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Mormeneo Bayo S, Bellés Bellés A, Prats Sánchez I, López González E, Aramburu Arnuelos J, Bernet Sánchez A, García González M. Fungal corneal abscess caused by Exophiala dermatitidis. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2023; 36:425-426. [PMID: 37079708 PMCID: PMC10336319 DOI: 10.37201/req/133.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 04/22/2023]
Affiliation(s)
- S Mormeneo Bayo
- Saray Mormeneo Bayo. Unidad de Microbiología. Hospital Universitari Arnau de Vilanova Lleida. Spain.
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5
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Reginatto P, Agostinetto GDJ, Fuentefria RDN, Marinho DR, Pizzol MD, Fuentefria AM. Eye fungal infections: a mini review. Arch Microbiol 2023; 205:236. [PMID: 37183227 PMCID: PMC10183313 DOI: 10.1007/s00203-023-03536-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023]
Abstract
Ocular fungal infections annually affect more than one million individuals worldwide. The management of these infections is problematic, mainly due to the limited availability of effective antifungal agents. Thus, ocular infections are increasingly recognized as important causes of morbidity and blindness, especially keratitis and endophthalmitis. Thus, this review aims to demonstrate the importance of fungal eye infections through the description of the main related aspects, with emphasis on the treatment of these infections. For this purpose, a search for scientific articles was conducted in databases, such as Medline, published from 2000 onwards, addressing important aspects involving fungal eye infections. In addition, this work highlighted the limited therapeutic arsenal available and the severity associated with these infections. Thus, highlighting the importance of constantly updating knowledge about these pathologies, as it contributes to agility in choosing the available and most appropriate therapeutic alternatives, aiming at positive and minimally harmful results for that particular patient.
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Affiliation(s)
- Paula Reginatto
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Giovanna de Jesus Agostinetto
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Melissa Dal Pizzol
- Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Alexandre Meneghello Fuentefria
- Laboratório de Pesquisa em Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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6
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Hwang CJ, Maltry AC, Harrison AR, Mokhtarzadeh A. A Case of the Blues-Colored Pencil Orbitopathy in an 18-Month-Old Boy. Ophthalmic Plast Reconstr Surg 2023; 39:e4-e8. [PMID: 35829627 DOI: 10.1097/iop.0000000000002248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Orbital penetrating injuries from pencils are rare. This report describes a case of penetrating orbital injury in a young child with a retained blue-colored pencil core foreign body, which led to rapid onset of orbital abscess requiring surgical drainage. Intraoperatively, orbital tissues were stained a bright-blue color. Histopathological study of specimen also highlighted bright blue aggregates of foreign material infiltrating the orbital tissues. Cultures grew Streptococcus mitis and Exophiala jeanselmei , which are rare causes of orbital abscess. Unique properties of retained colored pencil core as compared to graphite pencil core are herein discussed. Due to differences in composition, colored pencil core foreign bodies may require more timely surgical intervention compared to noncolored graphite pencil core.
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Affiliation(s)
- Christopher J Hwang
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, U.S.A
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Amanda C Maltry
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Andrew R Harrison
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Otolaryngology and Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Ali Mokhtarzadeh
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
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Froines CP, Connor N, Li E, Yoda RA, Gonzalez-Cuyar LF, Lu GN, Fu R, Zhang M. Breaking the mold: a case of recalcitrant eyelid subconjunctival infection by Exophilia Phaeomuriformis. Orbit 2021; 42:295-298. [PMID: 34694944 DOI: 10.1080/01676830.2021.1990968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While a rare ophthalmic pathogen, infections from Exophilia spp. are increasingly identified and have been associated with catastrophic vision loss. In this case report we present a previously undescribed manifestation of the melanin-producing fungus Exophilia Phaeomuriformis to the lower eyelid, establish an effective treatment, and review related cases. Previous cases of ophthalmic E. Phaeomuriformis were confined to the cornea and included iatrogenic tissue trauma. This case shares neither associations however includes a remote SJS history that likely led to changes in conjunctival tissue integrity. Previous cases of Exophilia spp. infecting the eyelid both included surgical source control and adjuvant antibiotic. In this case, topical therapy was deferred due to SJS-related ocular cicatricial disease. Fortunately, a full resolution was achieved with surgical resection and oral antifungal treatment.
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Affiliation(s)
- Colin P Froines
- Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Nathe Connor
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Emily Li
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Rebecca A Yoda
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, Washington, USA
| | - Luis F Gonzalez-Cuyar
- Department of Laboratory Medicine and Pathology, Division of Neuropathology, University of Washington, Seattle, Washington, USA
| | - G Nina Lu
- Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Roxana Fu
- Department of Ophthalmology, University of Pittsburg School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Matthew Zhang
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
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Usuda D, Higashikawa T, Hotchi Y, Usami K, Shimozawa S, Tokunaga S, Osugi I, Katou R, Ito S, Yoshizawa T, Asako S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Oba J, Nomura T, Sugita M. Exophiala dermatitidis. World J Clin Cases 2021; 9:7963-7972. [PMID: 34621853 PMCID: PMC8462220 DOI: 10.12998/wjcc.v9.i27.7963] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/03/2021] [Accepted: 08/24/2021] [Indexed: 02/06/2023] Open
Abstract
Exophiala is a genus comprising several species of opportunistic black yeasts, which belongs to Ascomycotina. It is a rare cause of fungal infections. However, infections are often chronic and recalcitrant, and while the number of cases is steadily increasing in both immunocompromised and immunocompetent people, detailed knowledge remains scarce regarding infection mechanisms, virulence factors, specific predisposing factors, risk factors, and host response. The most common manifestations of Exophiala infection are skin infections, and the most frequent type of deep infection is pulmonary infection due to inhalation. The invasive disease ranges from cutaneous or subcutaneous infection to systemic dissemination to internal organs. The final identification of the causative organism should be achieved through a combination of several methods, including the newly introduced diagnostic analysis, matrix-assisted laser desorption/ ionization-time-of-flight mass spectrometry, together with sequencing of the ribosomal ribonucleic acid internal transcribed spacer region of the fungi, and histological and culture findings. Regarding treatment, because anti-infective agents and natural compounds exhibited poor antibiofilm activity, few treatments have ultimately been found to be effective for specific antifungal therapy, so the optimal antifungal therapy and duration of therapy for these infections remain unknown. Therefore, most forms of disease caused by Exophiala dermatitidis require aggressive combination therapies: Both surgical intervention and aggressive antifungal therapy with novel compounds and azoles are necessary for effective treatment.
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Affiliation(s)
- Daisuke Usuda
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Toshihiro Higashikawa
- Department of Geriatric Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi-shi 935-8531, Toyama-ken, Japan
| | - Yuta Hotchi
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Kenki Usami
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Shintaro Shimozawa
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Shungo Tokunaga
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Ippei Osugi
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Risa Katou
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Sakurako Ito
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Toshihiko Yoshizawa
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Suguru Asako
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Kentaro Mishima
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Akihiko Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Keiko Mizuno
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Hiroki Takami
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Takayuki Komatsu
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Jiro Oba
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Tomohisa Nomura
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
| | - Manabu Sugita
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku 177-8521, Tokyo, Japan
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9
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Hoffman JJ, Burton MJ, Leck A. Mycotic Keratitis-A Global Threat from the Filamentous Fungi. J Fungi (Basel) 2021; 7:273. [PMID: 33916767 PMCID: PMC8066744 DOI: 10.3390/jof7040273] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 12/16/2022] Open
Abstract
Mycotic or fungal keratitis (FK) is a sight-threatening disease, caused by infection of the cornea by filamentous fungi or yeasts. In tropical, low and middle-income countries, it accounts for the majority of cases of microbial keratitis (MK). Filamentous fungi, in particular Fusarium spp., the aspergilli and dematiaceous fungi, are responsible for the greatest burden of disease. The predominant risk factor for filamentous fungal keratitis is trauma, typically with organic, plant-based material. In developed countries, contact lens wear and related products are frequently implicated as risk factors, and have been linked to global outbreaks of Fusarium keratitis in the recent past. In 2020, the incidence of FK was estimated to be over 1 million cases per year, and there is significant geographical variation; accounting for less than 1% of cases of MK in some European countries to over 80% in parts of south and south-east Asia. The proportion of MK cases is inversely correlated to distance from the equator and there is emerging evidence that the incidence of FK may be increasing. Diagnosing FK is challenging; accurate diagnosis relies on reliable microscopy and culture, aided by adjunctive tools such as in vivo confocal microscopy or PCR. Unfortunately, these facilities are infrequently available in areas most in need. Current topical antifungals are not very effective; infections can progress despite prompt treatment. Antifungal drops are often unavailable. When available, natamycin is usually first-line treatment. However, infections may progress to perforation in ~25% of cases. Future work needs to be directed at addressing these challenges and unmet needs. This review discusses the epidemiology, clinical features, diagnosis, management and aetiology of FK.
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Affiliation(s)
- Jeremy J. Hoffman
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (M.J.B.); (A.L.)
- Cornea Service, Sagarmatha Choudhary Eye Hospital, Lahan 56502, Nepal
- Department of Ophthalmology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (M.J.B.); (A.L.)
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Astrid Leck
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (M.J.B.); (A.L.)
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10
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Orbital Abscess—Two Case Reports with Review. Indian J Otolaryngol Head Neck Surg 2021; 74:1334-1343. [DOI: 10.1007/s12070-021-02486-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022] Open
Abstract
AbstractPeriorbital infections lead to severe condition of the orbital abscess, and eventually to sight loss, and even death. Current study aims in reviewing the literature regarding orbital abscess in adult patients and presenting 2 original cases. A surgical intervention to drain the abscess and a revision of the orbital was required. A review of literature is also reported focusing on aetiology and treatment options dealing with an orbital abscess.
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