Ethmoiditis with subperiosteal and retro-ocular abscesses due to Aeromonas sobria in a 16-year-old boy exposed to the Ardeche river

Description

A 16-year-old boy consulted for fever, left eyelid swelling, headache and vomiting. In the previous weeks, he reported having often bathed in the Ardèche river in France and has made many somersaults in jumping in the water. CT scan demonstrated filling of left ethmoid, maxillary and frontal sinuses with left eyelid infiltration and intraorbital extension. The patient was diagnosed with left ethmoiditis and was treated with intravenous amoxicillin–clavulanate. After 5 days of treatment, his fever had subsided but left exophthalmos, proptosis and ophthalmoplegia appeared with light reflex conservation (figure 1A). Fundus examination of the left eye was unremarkable, and dexamethasone and aminoside eye drops were added. A new CT scan was performed that showed an intraorbital and supraocular collection (9x23 mm) with left frontal sinus and left ethmoid opacification (figure 1B–D).

Figure 1

The 16-year-old boy with complicated ethmoiditis (A); CT scan revealed left...

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