Orbital Intraosseous Abscess After Lateral Bony Orbital Decompression

A 66-year-old woman status post bony lateral orbital decompression for thyroid eye disease presented with recurrent episodes of left lateral canthal edema and erythema, despite repeated courses of oral antibiotics, titanium hardware removal, and repeated exploratory orbitotomies with debridement and curettage. MRI later revealed an intraosseous fluid collection in the left greater sphenoid wing. Another exploratory orbitotomy was performed and an intraosseous abscess was identified. The purulent fluid was sent for culture, and the area was debrided and irrigated thoroughly with bacitracin solution. Cultures grew Staphylococcus epidermidis . The patient was treated with a 6-week course of intravenous antibiotics and has remained symptom free for 3 years.