Document Detail

Case report of orbital cellulitis and necrotizing fasciitis from melioidosis.
MedLine Citation:
PMID:  23303132     Owner:  NLM     Status:  MEDLINE    
A 48-year-old Thai male farmer presented with progressive swelling of the right eyelid and high-grade fever. His visual acuity declined and the right side of his forehead developed a necrotic skin lesion with a purulent discharge. CT of the orbits suggested orbital cellulitis with subperiosteal abscess. Intravenous ceftriaxone and clindamycin were given empirically but then switched to vancomycin and meropenem because of rapid deterioration together with clinical sepsis. Burkholderia pseudomallei was isolated from the blood 3 days after the treatment, and the antibiotics were then switched to intravenous ceftazidime. The liver enzymes were elevated, and imaging of the abdomen revealed liver and splenic abscesses. After 14 days, the patient showed marked clinical improvement, became afebrile, and regained his OD visual acuity. A repeat CT of the orbit showed improvement with no subperiosteal abscess. The antibiotic was then switched to oral trimethoprim/sulfamethoxazole in combination with doxycycline for 6 months.
Preamjit Saonanon; Suppapong Tirakunwichcha; Wirongrong Chierakul
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ophthalmic plastic and reconstructive surgery     Volume:  29     ISSN:  1537-2677     ISO Abbreviation:  Ophthal Plast Reconstr Surg     Publication Date:    2013 May-Jun
Date Detail:
Created Date:  2013-05-08     Completed Date:  2013-12-11     Revised Date:  2014-06-10    
Medline Journal Info:
Nlm Unique ID:  8508431     Medline TA:  Ophthal Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e81-4     Citation Subset:  IM    
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Bacteremia / diagnosis,  drug therapy,  microbiology
Burkholderia pseudomallei / isolation & purification*
Ceftazidime / therapeutic use
Eye Infections, Bacterial / drug therapy,  microbiology*,  radiography
Fasciitis, Necrotizing / drug therapy,  microbiology*,  radiography
Melioidosis / drug therapy,  microbiology*,  radiography
Middle Aged
Orbital Cellulitis / drug therapy,  microbiology*,  radiography
Tomography, X-Ray Computed
Grant Support
089275//Wellcome Trust
Reg. No./Substance:
0/Anti-Bacterial Agents; 9M416Z9QNR/Ceftazidime
Comment In:
Ophthal Plast Reconstr Surg. 2013 Sep-Oct;29(5):413   [PMID:  24022359 ]
Ophthal Plast Reconstr Surg. 2013 Sep-Oct;29(5):413   [PMID:  24022358 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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