From Group 2:
In orbital cellulitis, it was mentioned that the infection could reach the brain. With this, what are the possible neurological complications of the Group V classification of the disease?
Hi Karen! Hopefully, this answers your group’s question. :)
As orbital cellulitis may affect neighboring structures, neurological problems arise if the infection extends outside of the orbit. Potential complications may be:
> Cavernous sinus thrombosis (CST). The cavernous sinus is a paired dural venous sinus within the cranial cavity that may become infected in extreme situations. This may result in thrombosis (clot formation) in the cavernous sinus, which can impair cranial nerve function and cause neurological symptoms which include headache. Partial or total cranial neuropathies can result from localized compression and inflammation of the cranial nerves, including diplopia resulting from compression of the third (oculomotor), fourth (trochlear), and sixth (abducens) nerves, causing partial or total external ophthalmoplegia and the lack of the corneal blink reflex and numbness or paresthesias around the eyes, nose, and forehead are caused by the ophthalmic nerve, which is a branch of the trigeminal nerve (V) (Plewa, Tadi & Gupta, 2023).
> Intracranial Complications. In extreme circumstances, the infection may spread into the surrounding structures and cause intracranial problems. Other intracranial complications are meningitis, and intracranial, epidural, or subdural abscess formation which are characterized by altered level of consciousness (Gushchin, 2023).
References:
Plewa, M., Tadi, P. & Gupta, M. (2023). Cavernous Sinus Thrombosis.
https://www.ncbi.nlm.nih.gov/books/NBK448177/
Gushchin, A. (2023). Orbital Cellulitis. https://emedicine.medscape.com/article/1217858-overview?form=fpf
Going deeper, given that the Streptococci species is the most common bacterial organisms that cause orbital cellulitis (Danishyar & Sergent, 2023), bacterial spread through the bloodstream reaching the brain could eventually lead to meningitis. If left further untreated, fatal complications could include septic shock that is characterized by a dangerously low levels of blood pressure as a consequence of a severe infection (NHS, 2023).
References:
Danishyar, A., & Sergent, S. Orbital Cellulitis. National Center for Biotechnology Information. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK507901/#:~:text=The%20most%20common%20bacterial%20organisms,also%20been%20reported%5B2%5D.
Septic Shock. 2023. NHS inform. Retrieved from: https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/septic-shock/#:~:text=Septic%20shock%20is%20a%20life,to%20a%20reaction%20called%20sepsis.
References:
Danishyar, A., & Sergent, S. Orbital Cellulitis. National Center for Biotechnology Information. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK507901/#:~:text=The%20most%20common%20bacterial%20organisms,also%20been%20reported%5B2%5D.
Septic Shock. 2023. NHS inform. Retrieved from: https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/septic-shock/#:~:text=Septic%20shock%20is%20a%20life,to%20a%20reaction%20called%20sepsis.