ORBITAL CELLULITIS IN PULMONARY TUBERCULOSIS: A CASE REPORT.

Q4 Medicine
African Journal of Infectious Diseases Pub Date : 2020-07-31 eCollection Date: 2020-01-01 DOI:10.21010/ajid.v14i2.8
Ni Made Inten Lestari, Susy Fatmariyanti, Hendrian D Soebagjo, Neneng Dwi Kurniati, Delfitri Lutfi
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Abstract

Background: Orbital cellulitis in immunocompetent patients with pulmonary tuberculosis (TB) is rare or unheard of. If left untreated, patients might lose their sight and potentially their life. This case describes orbital cellulitis due to extended spectrum β-lactamases (ESBLs)-producing bacteria in a patient with pulmonary tuberculosis.

Materials and methods: We report the case of a 47-year-old man referred to the emergency room in our hospital with swollen and painful right eye and face for 8 days. On admission, the patient condition was drowsy, pale, and feverish. Visual acuity of the right eye was only light perception with limited eye movement in all directions. The CT scan showed orbital sub-tissue swelling and sub-periosteal abscess on the upper lateral orbital wall. On day 5, pus culture was confirmed as extended spectrum β-lactamases (ESBLs) producing bacteria and Ziehl-Neelson staining test revealed acid fast bacillus with pulmonary inflammation highly pathognomonic of tuberculosis.

Results: The patient showed significant clinical improvement on day 11. The patient was discharged on the day 15 in stable general condition with improved visual acuity on the right eye (capable of capturing hand movement).

Conclusion: ESBL producing bacteria associated orbital cellulitis in tuberculosis patient potentially elevated the morbidity and possibly result in severe loss of visual acuity. Early diagnosis and treatment could reverse this comorbidity and produce a better outcome for affected patients.

Abstract Image

Abstract Image

Abstract Image

肺结核眼眶蜂窝织炎1例。
背景:眼眶蜂窝织炎在免疫功能正常的肺结核(TB)患者中是罕见或闻所未闻的。如果不及时治疗,患者可能会失去视力,甚至可能失去生命。本病例描述了一位肺结核患者由广谱β-内酰胺酶(ESBLs)产生细菌引起的眼眶蜂窝织炎。材料与方法:我们报告一名47岁男性因右眼和面部肿胀疼痛8天而转至我院急诊室的病例。入院时,患者表现为昏睡、脸色苍白和发烧。右眼视敏度仅为光感,眼向各方向运动受限。CT示眶上外侧壁组织肿胀及骨膜下脓肿。第5天,脓液培养证实为广谱β-内酰胺酶(ESBLs)产生菌,Ziehl-Neelson染色检测显示抗酸杆菌伴肺部炎症,呈肺结核高病理特征。结果:患者在第11天临床表现明显改善。患者于第15天出院,一般情况稳定,右眼视力改善(能够捕捉手部运动)。结论:结核患者发生ESBL产菌相关性眼窝蜂窝织炎可能增加发病率,并可能导致严重的视力丧失。早期诊断和治疗可以扭转这种合并症,并为受影响的患者带来更好的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
African Journal of Infectious Diseases
African Journal of Infectious Diseases Medicine-Infectious Diseases
CiteScore
1.60
自引率
0.00%
发文量
32
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