Atypical presentations of orbital cysticercosis

Cysticercosis in ophthalmology

Cysticercosis is caused by Taenia solium, a cestode or tapeworm that preferentially affects the subcutaneous tissue, brain, muscle, and the eye. It is traditionally a disease of low socioeconomic regions, but large-scale population migration has made it a matter of global concern. Its ocular invasion is a potentially blinding disease. In the last two decades, there has been considerable discussion of cysticercosis; however, most comes from a limited number of case observations. Thus, to overcome this limitation, we summarize and analyse twenty years of medical literature (from 2000 to 2020) on cysticercosis in ophthalmology.

Orbital abscess with unusual features

PURPOSE

To report a series of 7 cases of orbital abscess with unusual features that may mimic other cystic orbital lesions.

METHODS

Retrospective study of all cases of orbital cellulitis/abscess treated at our center, over 1 year, highlighting cases with unusual features.

RESULTS

Thirty-one cases were studied, where orbital cellulitis/abscess was the final diagnosis. Of these, 7 patients did not have typical signs and/or symptoms of local infection. At presentation, there was no associated predisposing risk factor, indicating the source of infection. The duration of symptoms, among these 7 patients, ranged from 3 weeks to 6 months. The initial diagnosis was myocysticercosis in 3 cases, orbital dermoid in 1 case, lymphangioma in 1 case, pseudotumor in 1 case, and schwannoma in 1 case.

CONCLUSIONS

Unusual presentations of orbital abscess can mimic other conditions of the orbit. Orbital abscess should be considered in the differential diagnosis if a cystic lesion has not responded or partly responded to systemic antibiotics and there are associated signs or symptoms of intermittent or constant low-grade inflammation, even in the absence of predisposing risk factors.