• Bol Med Hosp Infant Mex · Mar 2017

    Case Reports

    [Orbital cellulitis complicated by subperiosteal abscess due to Streptococcus pyogenes infection].

    • José Daniel Ruíz Carrillo, Edwin Vázquez Guerrero, and Mónica Cecilia Mercado Uribe.
    • Médico Pasante del Servicio Social, Medicina Interna, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México. Electronic address: asrael_46@hotmail.com.
    • Bol Med Hosp Infant Mex. 2017 Mar 1; 74 (2): 134-140.

    BackgroundOrbital cellulitis is an infectious disease that is very common in pediatric patients, in which severe complications may develop. Etiological agents related to this disease are Haemophilus influenzae B, Staphylococcus aureus, Streptococcus pneumoniae and Moraxella catarrhalis, which correspond to 95% of cases. Moreover, Streptococcus beta hemolytic and anaerobic microorganisms may also be present corresponding to < 5% of the cases. We present an uncommon case of cellulitis complicated by sub-periosteal abscess caused by Streptococcus pyogenes (Group A beta hemolytic streptococcus).Case ReportA 9-year-old male patient with a history of deficit disorder and hyperactivity since 5 years of age. His current condition started with erythema in the external edge of the right eye, increase in peri-orbicular volume with limitation of eyelid opening, progression to proptosis, pain with eye movements and conjunctival purulent discharge. Image studies reported subperiosteal abscess and preseptal right with extraocular cellulitis. The patient started with empirical antibiotic treatment, surgical drainage and culture of purulent material from which Streptococcus pyogenes was isolated.ConclusionsDue to the implementation of vaccination schemes against H. influenza and S. pneumoniae since the 90s, the cases by these pathogens have decreased, causing new bacteria to take place as the cause of the infection. The importance of considering S. pyogenes as an etiology of orbital cellulitis is the rapid progression to abscess formation, and the few cases described in the literature.Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

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