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Orbital Compressed Air and Diesel Explosion Injury Resembling Orbital Cellulitis: An Unusual Case

Unusual clinical course, Mistake in diagnosis, Educational Purpose (only if useful for a systematic review or synthesis)

Yunia Irawati, Florentina Priscilia, Hindun Zakiyah

Indonesia Division of Plastic and Reconstructive Surgery, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Am J Case Rep 2021; 22:e929671

DOI: 10.12659/AJCR.929671

Available online: 2021-01-11

Published: 2021-02-21


#929671

BACKGROUND: In this observational case report, we describe a case of orbital cellulitis caused by blunt trauma from an orbital compressed air and diesel explosion injury.
CASE REPORT: A 44-year-old man presented to our emergency department with a marked clinical worsening of right upper eyelid swelling, accompanied by pain, fever, and redness. Four days prior, the patient’s right eye was struck by a pressurized diesel engine explosion. He sought treatment at another hospital, where an initial examination was conducted and a small laceration was found and immediately treated with irrigation and medication. The wound became progressively worse, and on examination at our hospital, we diagnosed orbital cellulitis, multiple abscesses, and pneumo-orbital formations. There was no indication of infection from the ears, nose, throat, and oral cavity, which usually causes orbital cellulitis. Drainage, debridement, incision, and necrotomy with orbital decompression (canthotomy and cantholysis procedure) was then performed on the patient.
CONCLUSIONS: Diesel explosion injury can cause orbital cellulitis which can appear to be a simple case at first but has a poor prognosis. Therefore, evaluating the patient’s trauma history, computed tomography scan, and histopathological examination are essential in establishing the diagnosis. As early as possible, a diagnosis should be made to prevent tissue damage due to inflammation. Surgical debridement and the administration of a corticosteroid and antibiotic were key to managing the presented case.

Keywords: Compressed Air, Explosions, Orbital Diseases



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