Orbital Inflammatory Syndrome Post Streptococcal Group A Pharyngitis: A Case Series
Author: Aleza Andron
Base Hospital / Institution: Shaare Zedek Medical Center
ePoster presentation
Abstract ID: 24-239
Purpose
Non-Specific orbital inflammation (NSOI)is a diagnosis of exclusion. It is a benign inflammatory process occurring in the orbit, without a known systemic disease. We report 2 cases young healthy patients presenting as NSIOI with radiologic evidence of myositis, with an underlying cause of post streptococcal pharyngitis complete resolution of symptoms with oral prednisone and no recurrence.
Methods
Retrospective case series
Results
Case 1: A ten-year-old boy presented with a two-week history of periorbital swelling, hyperemia and diplopia.He has significant left periorbital edema, proptosis and severe limitation of extraocular movements. CT scan with contrast demonstrated bilateral enlargement of the lateral recti, and left sided enlargement of the superior rectus and medial rectus with some optic nerve compression. A diagnosis of NSOI was presumed and oral steroids were prescribed with complete resolution of symptoms with no recurrence. On review of history, 6 weeks prior to presentation he was treated with amoxicillin for 10 days for culture positive group A strep pharyngitis and elevated ASLO. Thus, the diagnosis of post streptococcal orbital inflammatory syndrome was given.Case 2: A 22-year-old male presented with a two-month history of left orbital swelling. Physical examination revealed tenderness in the upper eyelid and mild proptosis. CT imaging showed enlargement of the left superior and lateral rectus muscles, and his blood test revealed an elevated antistreptolysin O (ASO) titer. The patient wastreated with prednisone 60 mg daily, resulting in complete resolution ofsymptoms within two weeks.
Conclusion
Post streptococcal orbital inflammatory syndrome is a rare post infectious entity. There have been limited case reports in the literature. Both cases affected multiple muscles and completely resolved with steroid treatment with no recurrence. It is an important entity to recognize in the pediatric population. These cases highlight the importance of testing ASLO titer in orbital myositis and demonstrates the efficacy of corticosteroid treatment in this subtype of NSIOI.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Elena | Drabkin | Shaare Zedek Medical Center |
