A rare cause of ptosis in emergency medicine practice: acute sinusitis case report
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Objective: Paranasal sinus infections are one of the most frequent causes of emergency service admissions. With increased incidence, complications are often local and classified according to the effecting side. Early identification of complication leads to reduce mortality and morbidity.
Case: A 22 year old male patient was admitted to our emergency department with ptosis on his right eyelid. Firstly he was admitted to the family doctor and received oral cephalosporin treatment for upper respiratory tract infection. Within three days, the ptosis was progressively occurred. No additional systemic sign was detected. The eyelid has slightly edema, not have redness, conjunctival hyperemia and loss of brow not observed. Eye movements were naturally, display pain in the outward view. For differential diagnosis central nervous system imaging was performed. Patient referred to otorhinolaryngology surgeon with prediagnosis of orbital cellulite and acute sinusitis. The patient was admitted to the otorhinolaryngology clinic for operation because of complicated sinusitis.
Conclusion: In the presence of acute sinusitis, infections may enter the orbital periosteum and spread to neighboring tissues. Computed tomography is a highly effective imaging modality for the evaluation of both paranasal infections and their complications. Patients with orbital complications must be hospitalized and immediate intravenous antibiotic therapy should be started.
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