Progression of Subperiosteal Orbital Abscess after Clinical Resolution on Intravenous Antibiotics and Steroids

ABSTRACT

We present a case of a 7-year-old boy who was presented with a small medial subperiosteal orbital abscess (SPOA) and trace superior phlegmon and who was initially treated with intravenous (IV) antibiotics, corticosteroids, and observation. After clinical resolution and discharge, the patient returned with superior migration of his abscess requiring surgical drainage. Potential factors leading to readmission are discussed, including the anti-inflammatory and immunosuppressant effects of steroids, and presence of early surgical indictors such as bony dehiscence and proptosis. This case highlights the need for careful consideration of initial imaging and presence of a non-medial phlegmon prior to initiation of steroids.

KEYWORDS:

• Intravenous steroids
• orbital cellulitis
• orbital phlegmon
• subperiosteal orbital abscess

Disclosure statement

University of Pittsburgh Medical Center IRB approval was waived as this was a case report. Informed consent was obtained from parents for publication. The medical records for the current study are not publicly available due to preserve patient confidentiality. The authors declare that they have no competing interests. The authors have no conflicts of interest or funding sources to disclose. All authors read and approved the final manuscript.

Additional information

Funding

This research acknowledges support from P30 CORE award EY08098 from the National Eye Institute, NIH, and unrestricted supporting funds from The Research to Prevent Blindness Inc, NY, and the Eye & Ear Foundation of Pittsburgh.