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목적 : Patients with hematologic malignancies are immunosuppressive and may develop cutaneous or invasive infections. The infection may be an initial sign of a malignancy or a sign of a relapse. We report an unusual case of necrotic orbital cellulitis in an immunocompromised patient.
방법 : An ill looking appearance 64-year-old woman presented with history of erythematous eyelid swelling in her right eye.
On the visual acuity examination in both eyes were intact. Right-sided proptosis with restriction of eye movements and severe chemosis were noted.
결과 : Laboratory blood examination and bone marrow biopsy showed bicytopenia and acute lymphoblastic leukemia. Within a few days, they developed a black necrotic change on margin with rapid progression. The paranasal sinuses were clear. Culture specimens from blood and eyelid lesion showed a significant growth of Pesudomonas aeruginosa species.
Intravenous and topical antibiotics were administered for treatment of orbital cellulitis. And necrosed or unhealthy skin on the roof of the abscess was excised and irrigated with normal saline and antibiotics frequently.
결론 : We report a rare case of an aggressive necrotic cellulitis on eyelid.
Cellulitis is an inflammation of loose connective tissue of dermal and subcutaneous tissue, and is caused by infection. Most cases with cellulitis show leukocytosis. However, cellulitis without leukocytosis may be present in patients with malignant hematologic disorders as shown here.
Opthalmologists and hematologists should keep in mind that patients with a hematologic malignancy, such as acute lymphoblastic leukemia, can develop cellulitis with leukocytopenia.
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