Bacterial orbital infection leading to orbital exenteration: a case series.
Robbert Cleymaet, Serge Schepers, Olivier Beckers et al.
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Case in brief
This case series describes three people who underwent orbital exenteration for bacterial infection. Two infections arose from odontogenic sources; the third was periorbital/orbital necrotizing fasciitis associated with a skin infection. All presented with clinical signs of orbital compartment syndrome and underwent multiple drainage procedures, but exenteration was ultimately required as a life-saving intervention. The patients were otherwise in good health at diagnosis, although one had a history of cancer in complete remission for more than 6 months. The series was drawn from patients receiving orbital prostheses between 2017 and 2024.
What made this case unusual
Severe bacterial orbital infection requiring exenteration occurred in people who were otherwise in good health at diagnosis; two cases had an odontogenic source.
Diagnostic / clinical pearl
Consider odontogenic and skin infections as potential sources of severe orbital infection, including in otherwise healthy patients presenting with orbital compartment syndrome.
Why it matters
The cases underscore the importance of prompt recognition and adequate treatment of infection, even when the patient is otherwise healthy.