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Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report
KEY CLINICAL MESSAGE: The nasopharyngeal swab for COVID‐19 is associated with low risks of severe complications, but it is important to consider the patient's medical history and anatomy of the nasal cavity to ensure safety and accuracy of the test. Orbital complications can occur up to 85% sec...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167616/ https://www.ncbi.nlm.nih.gov/pubmed/37180319 http://dx.doi.org/10.1002/ccr3.7324 |
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author | Abdul‐Kadir, Mohd‐Asyraaf Rosli, Abdul‐Hadi |
author_facet | Abdul‐Kadir, Mohd‐Asyraaf Rosli, Abdul‐Hadi |
author_sort | Abdul‐Kadir, Mohd‐Asyraaf |
collection | PubMed |
description | KEY CLINICAL MESSAGE: The nasopharyngeal swab for COVID‐19 is associated with low risks of severe complications, but it is important to consider the patient's medical history and anatomy of the nasal cavity to ensure safety and accuracy of the test. Orbital complications can occur up to 85% secondary to acute sinusitis, and prompt treatments are crucial, particularly in the pediatric group. A conservative approach is effective for subperiosteal abscess if certain criteria are met, and it is not an absolute indication for immediate surgical intervention. However, timely management of orbital cellulitis is essential for better outcomes. ABSTRACT: Pre‐septal and orbital cellulitis are more commonly seen in children than in adults. The incidence of pediatric orbital cellulitis is 1.6 in 100,000. The impact of COVID‐19 has led to the increasing practice of nasopharyngeal swab surveillance. We presented a case of rare pediatric orbital cellulitis complicated with subperiosteal abscess secondary to severe acute sinusitis following a nasopharyngeal swab. A 4‐year‐old boy was brought in by his mother with increasing painful left eye swelling and redness. Three days prior, the patient developed a fever and mild rhinitis with loss of appetite which raised concerns about COVID‐19. He had a nasopharyngeal swab on that same day and tested negative. Clinically, there was marked erythematous and tender periorbital and facial oedema involving the left nasal bridge, maxilla extended to the left upper lip with a deviation of the left nasal tip contralaterally. Computed tomography confirmed left orbital cellulitis with left eye proptosis, fullness of left maxillary and ethmoidal sinuses and left subperiosteal abscess. The patient received empirical antibiotics and surgical intervention promptly and recovered well with improvements in ocular symptoms. The nasal swabbing techniques may vary among practitioners, and it is associated with extremely low risks of severe complications from 0.001% to 0.16%. Whether the swab had aggravated the underlying rhinitis or traumatized the turbinates leading to sinus drainage obstruction; a nasal swab may impose the risk of severe orbital infection in a susceptible pediatric patient. Any health practitioner conducting the nasal swab should be vigilant about this potential complication. |
format | Online Article Text |
id | pubmed-10167616 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101676162023-05-10 Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report Abdul‐Kadir, Mohd‐Asyraaf Rosli, Abdul‐Hadi Clin Case Rep Case Report KEY CLINICAL MESSAGE: The nasopharyngeal swab for COVID‐19 is associated with low risks of severe complications, but it is important to consider the patient's medical history and anatomy of the nasal cavity to ensure safety and accuracy of the test. Orbital complications can occur up to 85% secondary to acute sinusitis, and prompt treatments are crucial, particularly in the pediatric group. A conservative approach is effective for subperiosteal abscess if certain criteria are met, and it is not an absolute indication for immediate surgical intervention. However, timely management of orbital cellulitis is essential for better outcomes. ABSTRACT: Pre‐septal and orbital cellulitis are more commonly seen in children than in adults. The incidence of pediatric orbital cellulitis is 1.6 in 100,000. The impact of COVID‐19 has led to the increasing practice of nasopharyngeal swab surveillance. We presented a case of rare pediatric orbital cellulitis complicated with subperiosteal abscess secondary to severe acute sinusitis following a nasopharyngeal swab. A 4‐year‐old boy was brought in by his mother with increasing painful left eye swelling and redness. Three days prior, the patient developed a fever and mild rhinitis with loss of appetite which raised concerns about COVID‐19. He had a nasopharyngeal swab on that same day and tested negative. Clinically, there was marked erythematous and tender periorbital and facial oedema involving the left nasal bridge, maxilla extended to the left upper lip with a deviation of the left nasal tip contralaterally. Computed tomography confirmed left orbital cellulitis with left eye proptosis, fullness of left maxillary and ethmoidal sinuses and left subperiosteal abscess. The patient received empirical antibiotics and surgical intervention promptly and recovered well with improvements in ocular symptoms. The nasal swabbing techniques may vary among practitioners, and it is associated with extremely low risks of severe complications from 0.001% to 0.16%. Whether the swab had aggravated the underlying rhinitis or traumatized the turbinates leading to sinus drainage obstruction; a nasal swab may impose the risk of severe orbital infection in a susceptible pediatric patient. Any health practitioner conducting the nasal swab should be vigilant about this potential complication. John Wiley and Sons Inc. 2023-05-09 /pmc/articles/PMC10167616/ /pubmed/37180319 http://dx.doi.org/10.1002/ccr3.7324 Text en © 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Case Report Abdul‐Kadir, Mohd‐Asyraaf Rosli, Abdul‐Hadi Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title | Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title_full | Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title_fullStr | Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title_full_unstemmed | Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title_short | Orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for COVID‐19: A case report |
title_sort | orbital cellulitis complicated with subperiosteal abscess following post‐nasopharyngeal swab for covid‐19: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167616/ https://www.ncbi.nlm.nih.gov/pubmed/37180319 http://dx.doi.org/10.1002/ccr3.7324 |
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