J Korean Diabetes > Volume 17(3); 2016 > Article
The Journal of Korean Diabetes 2016;17(3):219-223.
DOI: https://doi.org/10.4093/jkd.2016.17.3.219    Published online October 13, 2016.
당뇨병 환자에서 방선균에 의한 안와골막하농양 치료 1예
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A Case of Actinomycosis of an Orbital Subperiosteal Abscess in a Patient with Type 2 Diabetes Mellitus.
Jong Eun Park, Jae Bin Kang, Hyun Young Park, Ji Yeon Ahn, Jae Ho Shin, Kun Hee Lee, In Jin Cho, Yoo Cheol Hwang, Kyu Jeung Ahn, Ho Yeon Chung, In Kyung Jeong
1Department of Endocrinology and Metabolism, Head and Neck Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. jik1016@naver.com
2Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
3Department of Otorhinolaryngology, Head and Neck Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
Abstract
Orbital and paranasal actinomycosis have not been commonly reported. We report a case of this uncommon infection, which was improved after endonasal endoscopic drainage and antibiotics. A 53-year-old woman with type 2 diabetes mellitus complained of inability to lift her right upper eyelid and painful swelling over the preceding two days. Broad-spectrum antibiotics did not resolve her lesion. In ophthalmic examination, decreased visual acuity, upper and medial gaze limitation, and a relative afferent pupillary defect of her right eye were observed. Computed tomography of the orbit showed aggravated orbital cellulitis, preseptal cellulitis, subperiosteal abscess, and maxillary and ethmoid sinusitis. After endonasal endoscopic drainage and systemic antibiotics, her clinical symptoms dramatically improved. Microbiological analysis of the maxillary excisional biopsy showed Actinomycosis. This case is of interest due to the rare orbital presentation of actinomycosis infection and the importance of appropriate surgical drainage and long-term antibiotics treatment in such cases. Because delayed diagnosis and treatment of rhino-orbital actinomycosis can cause permanent vision loss or intracranial abscess, it requires careful clinical attention.
Key Words: Actinomycosis, Orbital cellulitis, Type 2 diabetes mellitus


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