Endophthalmitis caused by Mycobacterium chelonae: selection of antibiotics and outcomes of treatment.

malities of dentition. The disease generally progresses until puberty and may regress in adulthood. Radiologically, the radiolucent bony lesions are cystic and multiloculated in nature and are bilateral. These findings in conjunction with the clinical presentation are usually enough to make a diagnosis. Unless surgical intervention is needed for genetic or reconstructive purposes, a confirmatory biopsy is not obligatory. If a biopsy is performed, the histopathological differential diagnosis of lamellar bone formation with fibrous stroma and giant cell formation includes fibrous dysplasia, aneurysmal bone cyst, central giant cell granuloma of bone, and brown tumor of hyperparathyroidism. However, on the basis of clinical presentation and laboratory data, alternative diagnoses can be ruled out. Indications for treatment include functional problems, such as dental abnormalities and visual compromise, and the need for cosmesis. Treatment of choice is surgical curettage and contouring. Radiation therapy is not recommended because of risks of osteonecrosis and sarcoma transformation. We present a case of cherubism with documented visual loss secondary to optic neuropathy and macular chorioret inal folds/ scarring directly attributable to compression from the fibro-osseous growth within the orbit. To our knowledge, only 3 other cases of cherubism have been described in the ophthalmic literature. None of these cases presented with a relative afferent pupillary defect indicative of optic neuropathy. Although Hawes presented a patient with visual loss secondary to macular scarring, he did not attribute this to globe compression from the fibroosseous mass. Since most reports on this disease are presented in the oral maxillofacial and otorhinolaryngology literature (MEDLINE search of the past decade reveals 2 articles in ophthalmology journals and 37 in the two aforementioned fields), the focus is not on ophthalmic manifestations of disease and etiology of visual loss. It is therefore quite possible that visual loss from optic neuropathy and/or maculopathy secondary to cherubism is underestimated. As such, we feel that routine examination by an ophthalmologist be recommended in the management of a patient with cherubism.