Management of orbital complications of acute bacterial sinusitis: a case report and review of the literature

Abstract: - Introduction: Orbital complications of acute rhinosinusitis (ARS) are the most common extra-sinus manifestations, particularly in children and immunocompromised patients.They represent a medico-surgical emergency due to the anatomical proximity between the paranasal sinuses and the orbit, which facilitates infectious spread. Methods: We report the case of a 46-year-old female with poorly controlled type II diabetes who developed orbital cellulitis complicating an ipsilateral maxillary sinusitis. Clinical, radiological, and therapeutic aspects were analyzed and compared with data from the literature. Results: The patient presented with stage II Chandler orbital cellulitis. Diagnosis was established through clinical evaluation and computed tomography. Management consisted of broad-spectrum intravenous antibiotics combined with surgical drainage, leading to a favorable outcome without sequelae. Discussion: Orbital complications of ARS require early recognition and prompt intervention. The Chandler classification remains a valuable tool to stratify severity and guide treatment. Prognosis depends largely on early management, with blindness and intracranial extension being the most serious complications. Conclusion: This case highlights the importance of rapid diagnosis and appropriate medico-surgical management of orbital complications in ARS to prevent vision-threatening and life-threatening outcomes.