|
| Reference | Age/sex | Presentation | Medical history | Immune status | Treatment | Outcome |
|
| [4] | 42/F | Right temporal headache (3 wks), negative for dental infection. Orbital CT-ill-defined mass isodense with the brain, in the posterolateral part of the right orbit, right afferent pupillary defect, central scotoma, right proptosis, ↓ right corneal sensation, and loss of right ocular ductions. Presumed orbital infection vs. pseudotumor. | Low visual acuity → Count fingers (CF) | Not reported | Failed treatment for presumed orbital infection vs. pseudotumor: dexamethasone, empiric antibiotics, high-dose oral steroid treatment
Orbital exploration via lateral canthotomy approach, green, purulent drainage
Metronidazole, penicillin V + probenecid
| 3-month follow-up:
moderate right ptosis, mild right abduction weakness |
| [5] | 62/F | Left upper eyelid swelling, forehead and unilateral headache, bilateral frontal sinus tenderness, and discharging fistula in the lateral aspect of the upper eyelid. CT-the destruction of both inner and outer table of the skull with sequestrum formation in the left frontal sinus | Diabetes, left oroantral fistula after tooth extraction 1 year ago. | Immunocompromised | Left Caldwell-Luc for maxillary sinus drainage and fistula repair.
External approach to frontoethmoidectomy
Oral amoxicillin/clavulanate (8 wks)
Benzathine penicillin (6 mo.)
| Resolution |
| [8] | 54/M | Left purulent nasal discharge (1 month), swelling and sharp pain at the root of nose | Uncontrolled DM, chronic Hep C | Immunocompromised | IV ampicillin/sulbactam (6 days)
Oral amoxicillin (lost to f/u)
Surgical debridement of hard palate + nasal cavity
IV panipenem/betamipron + vancomycin → IV penicillin G (10 days) → d/c due to side effects (lost to f/u) | Death from multiorgan failure and DIC from disseminated infection |
| [10] | 37/M | Fever, severe frontal headache, left retrobulbar and hemifacial pain, nasal obstruction, diplopia, and absence of left lateral gaze | Unremarkable | Normal | Bilateral transethmoidal sphenoidectomy + extensive removal of the anterior left sphenoid wall.
IV vancomycin (2 wks), ceftriaxone, levofloxacin, pantoprazole, methylprednisolone
Oral amoxicillin/clavulanic acid (8 wks) + saline nasal irrigations
| Resolution |
| [17] | 18/M | Fever, frontal headache, and bilateral papilledema. CT-ring-enhancing cystic mass in the right frontal lobe | Recurrent rhinopharyngitis | Normal | IV ciprofloxacin-metronidazole
Oral erythromycin
x | Resolution |
| [18] | 35/M | Left eye proptosis and ptosis. CT-left pansinusitis and subdural empyema, cerebral edema with midline shift | Dental extraction | Not reported | IV cefotaxime-metronidazole
Bedside percutaneous twist-drill aspiration (25 cc purulent material cultured)
Frontotemporoparietal craniotomy and superior orbitotomy
Penicillin (2 wks.)
Oral tetracycline (4 wks.)
| Resolution |
| [19] | 43/M | Episodic left facial and temporal pain (2 months), acute onset diplopia, abducens nerve palsy, CT, and MRI-bilateral cavernous sinus swelling | Dental caries | Not reported | Oral corticosteroids (for presumed Tolosa Hunt syndrome)
MRI → return of cavernous sinus swelling → pterional craniotomy +
V penicillin (8 wks) + oral penicillin (3 mo.) | Resolution |
|
