Epidural empyema secondary to orbital cellulitis: A case report.

PURPOSE To report a case of epidural empyema, a rare complication of orbital cellulitis, underlining the importance of early diagnosis and appropriate therapy to avoid severe complications often associated with this disease. METHODS The treatment was initiated with extended spectrum antibiotics such as third generation cephalosporins along with aminoglycoside or metronidazole for anaerobes. RESULTS The patient responded well and was asymptomatic after 15 days. Radiologic investigations (computed tomography/magnetic resonance imaging) should be done on an emergency basis. Treatment should be aggressive with parenteral use of extended spectrum antibiotics. The role of steroid is when proptosis is causing lagophthalmos with exposure keratitis and/or optic nerve compression. Judicious surgical intervention can be life saving in this emergency. Peribulbar antibiotic injection has no role in the therapy. CONCLUSIONS The authors present a unique case of epidural empyema secondary to orbital cellulitis associated with an episode of epileptic seizure.