DR. PRIYAMVADA YADAV

DR. MANISHA RATHI, DR.. SWEETY DHANIA, DR.ANSHU KHATRI

Abstract

A 9 year old boy presented with two days of fever, cold, sudden proptosis and decreased vision left eye. He had nasal bleed, headache 4 days ago. On examination, he had vision of counting fingers at 1meter, proptosis, conjunctival chemosis, congestion, mild corneal exposure, total ophthalmoplegia, RAPD, fundus was normal. There was nasal discharge on pressure on medial canthal area. He was started on broad spectrum antibiotics. Imaging revealed copious gas suggestive of anaerobic etiology along with sinusitis. Functional endoscopic sinus surgery was done after 2 days. Differentials were mucormycosis, Wegener granulomatosis (nasal bleed, multiple sinus involvement), cavernous sinus thrombosis, septicemia, thyroid ophthalmopathy. Other differentials were ruled out after appropriate testing. After 10 days, vision was 6/9. At 3 months, extraocular movements were full, vision 6/6.

Immediate and appropriate integrated multi-specialty management can salvage eye, vision and life of patients.