Fusobacterium necrophorum Orbital Cellulitis With Intraconal Abscess

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 7; p. e41415
• Main Authors: Otte, Benjamin P, Harris, Justin P, Schulte, Alexandra J, Davies, Brett W, Brundridge, Wesley L
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 05.07.2023; Cureus
• Subjects: Abscesses; Antibiotics; Cellulitis; Emergency medical care; Eye movements; Hospitalization; Medical imaging; Ophthalmology; Optic nerve; Otolaryngology; Pathogens; Sinuses; Sinusitis; Visual acuity; orbital cellulitis; fusobacterium necrophorum; intraconal; allergic fungal sinusitis; orbital abscess
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.41415

A 19-year-old male presented to the emergency department with progressive right eye proptosis and was subsequently diagnosed with bacterial orbital cellulitis and acute on chronic allergic fungal sinusitis. He experienced brief symptomatic improvement after endoscopic sinus surgery, initiation of antibiotics, and steroid treatment; however, he re-presented five days after discharge with significantly worsened symptoms and no light perception in the right eye. Cultures resulted in Aspergillus and , a rare, aggressive etiology of bacterial orbital cellulitis. He developed an intraconal abscess requiring multiple orbitotomies for decompression and abscess drainage. To our knowledge, only eight prior cases of  orbital cellulitis have been reported in the literature (excluding the present case) and our patient is the first case of this organism causing an intraconal abscess. The authors discuss the importance of early recognition and close follow-up of orbital infections.