{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:40:19Z","timestamp":1756366819995,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,1]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>A man in his twenties with a history of recurrent sinusitis was urgently referred to the emergency department (ED) by an out-of-hours general practitioner following a 2-day history of increasing right eye pain, redness and swelling after a week of coryzal symptoms. He denied visual impairment and any history of recent dental pain or procedures. Initial assessment in ED noted fever, tachycardia and hypotension. Video consultation with ophthalmologist in the ED identified proptosis, periorbital erythema and chemosis with full eye movement solely affecting the right eye. Visual acuity of 6\/6 was confirmed in both eyes. After review by the ear, nose and throat (ENT) team, a diagnosis of sinogenic right orbital cellulitis was made, empirical antibiotics started and care transferred to the ENT team for immediate surgical intervention. 48\u2009hours postoperatively, the patient acutely deteriorated, developing ophthalmoplegia and visual acuity of 6\/95 in the right eye. Repeat imaging demonstrated a deteriorating picture and urgent surgery was organised at a neighbouring hospital\u2019s specialist ENT unit combined with a change to his antibiotics. On day 4, 1\u2009day following transfer, an anaerobic bacterium, <jats:italic>Eggerthia catenaformis,<\/jats:italic> was isolated from blood cultures collected on admission. The patient improved clinically following the second surgery and targeted antimicrobial therapy, eventually being discharged 10 days after initial presentation. In addition to <jats:italic>E. catenaformis<\/jats:italic>, the Anaerobic Reference Unit (Cardiff) identified two further anaerobic bacteria, <jats:italic>Parvimonas micra<\/jats:italic> and <jats:italic>Dialister pneumosintes<\/jats:italic>. This paper presents the first documented case of polymicrobial anaerobic orbital cellulitis secondary to acute bacterial sinusitis. Moreover, this case underpins the importance of broad empirical antibiotics coupled with surgical source control to effectively manage a rare but sight-threatening and life-threatening disease.<\/jats:p>","DOI":"10.1136\/bcr-2021-248473","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T12:04:12Z","timestamp":1648555452000},"page":"e248473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Sinogenic polymicrobial anaerobic orbital cellulitis: the importance of source control and broad empirical antibiotics"],"prefix":"10.1136","volume":"15","author":[{"given":"Andrew","family":"Blunsum","sequence":"first","affiliation":[{"name":"Infectious Diseases & General Internal Medicine, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Treharne","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, NHS Lanarkshire, Airdrie, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theofano","family":"Tikka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arunachalam","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, NHS Lanarkshire, Airdrie, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elan Micha","family":"Tsarfati","sequence":"additional","affiliation":[{"name":"Department of Microbiology, NHS Forth Valley, Larbert, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,29]]},"reference":[{"key":"2025082800085268000_15.3.e248473.1","unstructured":"Danishyar A , Sergent SR . 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