Three-year-old Gnaneshwar, could have suffered from visual impairment for a lifetime, if medical attention was delayed any further. When this little boy was suffering from red and swollen right eye, nobody thought this could lead to severe complications.
A Pediatrician at a nearby clinic prescribed syrups and topical eye drops, which didn’t help. “The next morning after we consulted the Pediatrician, my son was very dull and denied eating food. We thought he will get better, but his temperature went up to 103 degrees following itchiness, redness in the eyes and severe headache,” recollected Jamuna, Gnaneshwar’s mother and a housewife.
Gnaneshwar, who was diagnosed as viral illness and conjunctivitis, was then referred to Columbia Asia Hospital, Whitefield. On reaching the hospital, he was immediately rushed to emergency room for administration of IV antibiotics.
After a pre-examination following a CT scan, he was diagnosed to have right sided orbital cellulitis and abscess with ethmoid sinusitis. After opinions from Dr. Deepali Prabhu, Ophthalmologist and Dr. Debashish, ENT specialist, he was operated for endoscopic decompression of Orbital abscess, the next morning.
“From the first look at this sick child, I understood it was something uncommon. Therefore, we didn’t delay administration of antibiotics and resuscitated with IV fluid boluses. The child suffered from sinusitis and then developed orbital cellulitis and abscess, where pus gets collected in the optical area with prominent redness in the eyes. There’s a tiny amount of space at the back of the eye where even small amount of pus can develop and timely removal of this pus is important before it presses the optic nerve or neighbouring area. If not treated immediately, it can spread and result in blindness or vision loss,” explained Dr. Sanjay D Swamy, Consultant – Paediatrician & Paediatric Intensivist, Columbia Asia Hospital, Whitefield, Bangalore.
The infections of the orbits are rare and can be potentially devastating in both adults and children, resulting in blindness, meningitis or death. The frequency of orbital complications from sinus infection ranges from 0.5% to 3.9%. However the incidence of orbital or periorbital abscesses varies considerably from 0% to 25% in paediatric age group in different studies.
People who have had a respiratory infection, sinusitis, and ocular or periocular infection, systemic infection or have had any trauma to the eye are at high risk of obtaining the orbital cellulitis infection.
“We do not see such cases very often where sinusitis develops into orbital cellulitis and further leads to abscess. If the child was brought at the orbital cellulitis stage, we would have treated it medically. But, since he was referred to the hospital after developing abscess, the pus was evacuated endoscopically. So, if a child is suffering from cold and fever with swelling near the eye region for some day’s parents should immediately consult a multi-speciality hospital,” said Dr. Debasish Datta Majumder, Consultant – ENT, Columbia Asia Hospital, Whitefield, and Bangalore.
Post-operation Gnaneshwar showed gradual improvement and was under observation for 8 days. Considering the seriousness of the infection he was advised IV antibiotics for 2 weeks.
“We were very worried because the disease was wrongly diagnosed initially but then the correct diagnoses and treatment by the team of doctors at Columbia Asia hospital totally recovered our child’s health. It’s a lesson for us to not neglect long running fever with cold and immediately consult a multi-speciality hospital,” said Rammohan, Gnaneshwar’s father who works in IT sector.