Burkholderia Cepacia Orbital Cellulitis Causing Blindness: A Case Report.
Christina WK NG1,2, SL NG3, Zabri K1
1Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor, Malaysia, 2Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, and 3Department of Ophthalmology, Hospital Taiping, Taiping, Perak, Malaysia.
Burkholderia cepacia is an aerobic gram-negative bacillus with multidrug resistance found in various moist environments. It has been reported in keratitis and endophthalmitis. We described a case of Burkholderia cepacia orbital cellulitis, which believed to be the first reported case. A 71-year-old gentleman with underlying poorly controlled Type 2 diabetes mellitus and hypertension, presented with left eye sudden blindness and complete ptosis for one day. On examination, left eye was non-perceptive to light with positive relative afferent pupillary defect, mild proptosis, chemosis, complete ptosis and total ophthalmoplegia. Eye swab culture revealed Burkholderia cepacia. Culture for fungal growth was negative. Despite treatment with intravenous cloxacillin, ceftriaxone and metronidazole, and later vancomycin, the nerve dysfunction and visual loss were irreversible. Bacterial orbital cellulitis rarely presents with blindness. This case represents the virulent nature of Burkholderia cepacia.
Keywords: orbital cellulitis, Burkholderia cepacia, blindness, ophthalmoplegia, virulence
Correspondence author: Christina Wei Khee Ng, Department of Ophthalmology, Hospital Selayang. Lebuhraya Selayang-Kepong. 68100 Batu Caves. Selangor. Malaysia/Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Brunei Int Med J. 2017; 13 (3): 96-100