Struggling dilemma: A girl's dental problem led to a potentially fatal eye infection
A unique case of orbital cellulitis, a serious eye infection, has been reported in a 6-year-old girl from the West Bank. Unlike the more common pathway where orbital cellulitis stems from sinus infections, this case originated from a dental issue.
The girl initially experienced a toothache near her back-right molars, accompanied by a headache, swelling around her right eye, and a fever of 104 degrees Fahrenheit (40 degrees Celsius). As the condition worsened, she developed double vision, light sensitivity, and a severely swollen, shiny, flushed, and warm right eye that bulged from the socket.
Upon admission to a hospital pediatric ward, the girl was given intravenous antibiotics, including vancomycin, for hard-to-treat bacterial infections such as methicillin-resistant Staphylococcus aureus (MRSA). Ophthalmologists determined that the girl's eye swelling was caused by a bacterial infection known as orbital cellulitis, which affects fat and muscle tissues around the eye but not the eye itself.
A CT scan of the girl's head revealed inflamed sinus cavities that appeared opaque on the scan, with swollen tissues displacing fat layers around the eye and an accumulation of pus in the eye socket. The doctors surgically removed the abscess to relieve the pressure on the patient's eye, extracted two infected teeth, created a drainage opening in the patient's sinuses, and removed several polyps that had formed in her sinus cavity. The girl continued to receive intravenous antibiotics, and her condition improved. At a follow-up visit eight months later, her eye appeared normal, with no loss of vision or mobility.
This case is one of only four such examples described in medical literature where orbital cellulitis was traced back to a dental issue in a child. Given the rarity of dental-related cases, it is essential for healthcare providers to consider other sources of infection when diagnosing orbital cellulitis.
It is important to note that this article is for informational purposes only and does not provide medical advice. Orbital cellulitis can cause permanent vision loss by damaging blood vessels and nerves in the eye and can spread to the bloodstream or brain, leading to life-threatening complications. If you suspect that you or your child may have orbital cellulitis, seek immediate medical attention.
References: 1. Orbital cellulitis in children: a rare dental origin 2. Orbital cellulitis in children: a review of 50 cases 3. Orbital cellulitis in children: etiology, diagnosis, and management
