A Challenging case of paediatric orbital abscess

Abstract

Abstract : A 5 yr old girl who presented to us with redness
and pain in the right eye of 4 days duration , fever with boils 3
days and lid swelling 1 day. Gives history of taking eye drops,
injections and IV fluids at a local hospital. Right eye vision
was perception of light with inaccurate projection of rays. Lid
oedema, congestion, epithelial oedema, cells, flare and
exudates and raised IOP. Left eye had vision 66 with normal
clinical findings. B-scan showed mass in the infero-temporal
quadrant with total retinal detachment. CT-scan showed
nodular enhancing lesion without calcification.WBC count
15,400 cellscumm, ESR - 90mmhr.Later developed proptosis,
iris seeding and multiple swelling over axillary area, shin and
left lateral abdominal wall which were non-tender and
non-mobile. CT-Scan confirmed it to be multiple abscesses.
Frozen Section from eyelid swelling showed features of
granulation tissue. She was on systemic and topical
antibiotics, later on switched over to oral antibiotics . All her
abscesses had resolved completely and she was discharged
with a vision of perception of light. On 1 month follow up her
right eye had become phthisical and she was fitted with a
custom prosthesis.
Keyword :Endogenous endophthalmitis, abscess, retinoblastoma.