Vol 5 (2020): Continuous Publishing
Case report
Published online: 2020-07-09

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Intraorbital wooden foreign body — a case report

Piotr Kanclerz1, Agnieszka Chrząszcz-Włodarczyk2, Andrzej Grzybowski3
Ophthalmol J 2020;5:51-54.

Abstract

Background: Wood as an intraorbital foreign body (IOFB) is infrequent, and as it is organic matter patients represent an increased risk of infection. The aim of this study is to report the complexity of treatment of patient with a wooden IOFB. We describe a case of a 67-year-old male with a wooden IOFB.

Case report: On referral, the patient presented with exophthalmos, pain, blurry vision and discharge from his left eye was admitted to the Department of Ophthalmology, Medical University of Gdańsk. The previous evening, he fell with his face down. Computed tomography revealed a low-density IOFB of approximately -980 Hounsfield Units, sized 62 × 8 mm, in the area of left orbit, ethmoid and sphenoid sinus. Subsequently, the IOFB was removed under general anaesthesia. After three days of empirical antibiotic therapy, the patient was discharged with a switch to oral antibiotics. Shortly after the conversion to oral therapy, he developed an orbital inflammatory syndrome and was readmitted to the hospital. His condition improved after readministration of parenteral antibiotics.

Conclusion: This case demonstrates that wooden IOFBs should be treated with caution. Parenteral antibiotic delivery leads to higher serum levels than with oral intake, and in this case, was essential in preventing infection after IOFB removal.

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References

  1. Shelsta HN, Bilyk JR, Rubin PAD, et al. Wooden intraorbital foreign body injuries: clinical characteristics and outcomes of 23 patients. Ophthalmic Plast Reconstr Surg. 2010; 26(4): 238–244.
  2. Malik N. Benign Tumors of the Jaw Bones. In: Malik N. ed. Textbook of Oral and Maxillofacial Surgery. Jaypee Brothers Medical Pub 2016: 674–734.
  3. Zhou L, Li SY, Cui JP, et al. Analysis of missed diagnosis of orbital foreign bodies. Exp Ther Med. 2017; 13(4): 1275–1278.
  4. Taş S, Top H. Intraorbital wooden foreign body: clinical analysis of 32 cases, a 10-year experience. Ulus Travma Acil Cerrahi Derg. 2014; 20(1): 51–55.
  5. John SS, Rehman TA, John D, et al. Missed diagnosis of a wooden intra-orbital foreign body. Indian J Ophthalmol. 2008; 56(4): 322–324.
  6. Li J, Zhou LP, Jin J, et al. Clinical diagnosis and treatment of intraorbital wooden foreign bodies. Chin J Traumatol. 2016; 19(6): 322–325.
  7. van der Wal KG, Boukes RJ. Intraorbital bamboo foreign body in a chronic stage: case report. Int J Oral Maxillofac Surg. 2000; 29(6): 428–429.
  8. Glatt H, custer p, Barrett L. Magnetic Resonance Imaging and COmputead Tomography in a Model of wooden Foreign Bodies in the orbit. Ophthal Plast Reconstruct Surg. 1990; 6(4): 290.
  9. Krimmel M, Cornelius CP, Stojadinovic S, et al. Wooden foreign bodies in facial injury: a radiological pitfall. Int J Oral Maxillofac Surg. 2001; 30(5): 445–447.
  10. McGuckin JF, Akhtar N, Ho VT, et al. CT and MR evaluation of a wooden foreign body in an in vitro model of the orbit. AJNR Am J Neuroradiol. 1996 Jan; 17(1): 129–33.
  11. Nishio Y, Hayashi N, Hamada H, et al. A case of delayed brain abscess due to a retained intracranial wooden foreign body: a case report and review of the last 20 years. Acta Neurochir (Wien). 2004; 146(8): 847–850.
  12. Spiegelhauer MR, Andersen PF, Frandsen TH, et al. Leclercia adecarboxylata: a case report and literature review of 74 cases demonstrating its pathogenicity in immunocompromised patients. Infect Dis (Lond). 2019; 51(3): 179–188.
  13. Fiedler G, Schneider C, Igbinosa EO, et al. Antibiotics resistance and toxin profiles of Bacillus cereus-group isolates from fresh vegetables from German retail markets. BMC Microbiol. 2019; 19(1): 250.
  14. Duerink DO, Lestari ES, Hadi U, et al. Study Group Antimicrobial Resistance in Indonesia: Prevalence and Prevention (AMRIN). Determinants of carriage of resistant Escherichia coli in the Indonesian population inside and outside hospitals. J Antimicrob Chemother. 2007; 60(2): 377–384.
  15. Enenkel S, Stille W. Administration of AntiBiotics. Antibiotics in the Tropics. 1988: 39–40.
  16. Shrayteh ZM, Rahal MK, Malaeb DN. Practice of switch from intravenous to oral antibiotics. Springerplus. 2014; 3: 717.