After three days of fever, the 5-year-old girl’s left eye was swollen and the eyeball bulged out of the eye socket due to complications from sinusitis. Doctors performed emergency surgery to save her eyesight.
On November 5, Dr. Vo Le Khanh Hung, Department of Ophthalmology and Refractive Surgery, FV Hospital, said that a Chinese child patient living in Ho Chi Minh City, his pupil reflexes no longer responded, signs of very serious damage. If not intervened promptly, this condition can lead to compression of the optic nerve, or even complete loss of vision.
Doctor Vo Le Khanh Hung examines a pediatric patient. Image: Hospital provided
CT scan and fluid culture test showed that the baby had an orbital abscess caused by multiresistant Staphylococcus aureus, starting from sinusitis. The infection is located close to the central nervous system and can spread to the meninges, causing encephalitis, loss of vision or death.
Faced with the rapid progression of the disease, doctors from the Ophthalmology, Ear, Nose and Throat, Pediatrics and Infectious Diseases departments consulted and agreed on emergency surgery, because if only antibiotic treatment was used, the “golden time” would be missed. In a case of soft tissue abscess or orbital abscess, complete abscess drainage is vital. Otherwise, antibiotics will have difficulty penetrating the infected area, causing prolonged and ineffective treatment.
The surgical team drained the orbital abscess combined with sinus curettage on the same day. Eye doctors drilled into the outer wall of the eye socket, removed all the pus to decompress, then the Ear, Nose and Throat doctor scraped out the entire left ethmoid sinus, opening a clear path between the sinus and the eye socket to avoid recurrence.
“The abscess drainage line is close to the brain area, just a small mistake can cause meningitis or death, so all operations must be extremely meticulous,” said Dr. Hung.
Doctors operate on patients. Image: Hospital provided
The surgery lasted nearly two hours, successfully resolving the pus and cleaning the source of infection in the sinus. After surgery, the baby received specific antibiotic treatment with a prolonged infusion regimen to increase the ability to penetrate the infected area. A few days later, the baby’s fever disappeared, swelling decreased, and vision gradually recovered.
Dr. Vo Cong Minh, Head of the Department of Ear, Nose and Throat, said sinusitis causing deep abscesses in the eye socket is a relatively rare case, but can get worse very quickly, threatening vision and even life. Symptoms occur slowly and are often mistaken for common symptoms of fever and runny nose. When there are clear signs, the patient is in a serious condition, treatment is difficult, and there are many risks.
Doctors recommend taking your child to the doctor immediately if they have severe rhinitis, sore throat, prolonged fever, fatigue or swelling in the face or around the eyes. If the disease does not improve after a few days, do not wait for it to go away on its own, because acute sinusitis can cause many serious complications or become chronic.