PMC7648554_01
CT of the brain and orbits (coronal (A) and axial (B) sections) showing signs of orbital cellulitis (significant left-sided proptosis, inflammation and fat stranding of the periorbita and within the left orbit) and a filling defect within the left cavernous venous sinus, suggestive of a cavernous sinus thrombosis.
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CT imaging showed proptosis of the left globe, left intraconal soft tissue enhancement with scleral thickening, and an enlarged left superior ophthalmic vein with features of cavernous sinus thrombosis (Figure 1).
Examination under anesthetic demonstrating marked chemosis, dense corneal infiltrate with a large hypopyon and periorbital erythema. Note the purulent fluid aspirated from vitreous tap.
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A second EUA was performed two days later, and with no clinical improvement in the hypopyon or keratitis, a second vitreous tap and antibiotic injection was performed showing the vitreous cavity filled with pus (Figure 2).
(A) Cross-section of the left globe following enucleation and (B) histology slide showing severe neutrophilic inflammation within the sclera, uvea, and retina.
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Histopathological analysis showed neutrophilic panophthalmitis with extensive suppurative inflammation within the sclera, retina, and uveal tissue, associated with stromal melt and mild optic nerve inflammation (Figure 3).