Muhammad Shafiq Advani
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Managing Periorbital Necrotizing Fasciitis: How Invasive Should We Go? Poster Presentation - Case Report - Resident Andi Marsa Nadhira; Lia Amanda; Muhammad Shafiq Advani; Lukman Edwar
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/0yb71086

Abstract

Introduction : Periorbital necrotizing fasciitis (PNF) is rapidly progressive and severe infection that may result in vision loss, serious facial disfigurement, and death. Primary management includes surgical debridement; however, here we report a case in which conservative approach resulted in favorable resolution. Case Illustration : A 24-year-old male presented with swollen right upper eyelid, with watery eye, pain, and blurry vision since 1 week prior. No history of trauma or known systemic diseases was reported. Restricted movement of the right eye (RE), slight nonaxial proptosis, and skin defect along the right superior palpebra with pus, blood, necrotic and granulation tissues were found. Visual acuity (VA) of RE decreased to 6/40 with normal intraocular pressure. No abnormalities on the left eye, fever, and other signs of systemic involvement were present. Contrast orbital computed tomography (CT) scan revealed right preseptal and postseptal tissue lesions, suggesting orbital cellulitis. Initial blood work showed leukocytosis, elevated neutrophil and lymphocyte counts, and high liver function markers. The diagnosis of right orbital cellulitis with PNF was established. Skin swabs and blood cultures were taken, while intravenous ampicillin-sulbactam, bedside wound debridement, and chloramphenicol ointment application were initiated. The swab culture later showed Acinetobactersp. The infection improved, VA was restored to 6/6, and wound closure was achieved without any surgery. Discussion : Management of necrotizing fasciitis localized in periorbita in an otherwise healthy patient may be successfully accomplished with a less invasive approach. Conclusion : Timely diagnosis and correct antibiotic therapy are mandatory to decrease morbidity and mortality related to PNF.
MULTIPLE GIANT CHALAZIA IN HYPERIMMUNOGLOBULINEMIA E SYNDROME: A CASE REPORT: Poster Presentation - Case Report - Resident Lily Raudah Putri; Florentina Priscilia; Dany Petra Pranata Barus; Annisa Windyani; Muhammad Shafiq Advani; Lukman Edwar
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/8gxvc748

Abstract

Introduction : Hyperimmunoglobulinemia E syndrome (HIES) is a rare primary immunodeficiency disorder that manifests as elevated level of serum immunoglobulin E (IgE) higher than 1.000 IU/mL and multisystem disorder characterized by recurrent skin and pulmonary abscesses caused by autosomal dominant or recessive disorder with gene mutation. We present a case of multiple giant chalazion ina patient with HIES. Case Illustration : A 15-year-old boy was referred to Ophthalmology Department with multiple giant lumps on the left eyelid for the last 2 weeks. He had a history of recurrent multiple lumps on the left lower eyelid in the last 1 year. He was diagnosed with HIES since 8 years ago. He had normal visual acuity of both eyes. Multiple giant chalazion were observed on the left upper and lower eyelid. The patient also presented with scalp and neck infection. Laboratory studies showed elevated total serum IgE level of 53,032 IU/mL and eosinophilia. Discussion : Ocular manifestations in HIES patients are not common. Some cases reported chalazia, keratoconus, and blepharitis. Surgical incision drainage was performed in our patient. Medications and surgical intervention had produced only transient improvement. The patient was treated conservatively. Riskof chalazia recurrence remains unknown as reported cases presented with diverse clinical presentation and follow-up serum IgE evaluation is not routinely performed. Conclusion : Recurrent multiple giant chalazia may occur as an ophthalmic feature of HIES. HIES should be considered and investigated in patients presenting with recurrent giant chalazia.
MULTIPLE GIANT CHALAZIA IN HYPERIMMUNOGLOBULINEMIA E SYNDROME: A CASE REPORT: Poster Presentation - Case Report - Resident Lily Raudah Putri; Florentina Priscilia; Dany Petra Pranata Barus; Annisa Windyani; Muhammad Shafiq Advani; Lukman Edwar
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/6c6g4758

Abstract

Abstract Introduction : Hyperimmunoglobulinemia E syndrome (HIES) is a rare primary immunodeficiency disorder that manifests as elevated level of serum immunoglobulin E (IgE) higher than 1.000 IU/mL and multisystem disorder characterized by recurrent skin and pulmonary abscesses caused by autosomal dominant or recessive disorder with gene mutation. We present a case of multiple giant chalazion ina patient with HIES. Case Illustration : A 15-year-old boy was referred to Ophthalmology Department with multiple giant lumps on the left eyelid for the last 2 weeks. He had a history of recurrent multiple lumps on the left lower eyelid in the last 1 year. He was diagnosed with HIES since 8 years ago. He had normal visual acuity of both eyes. Multiple giant chalazion were observed on the left upper and lower eyelid. The patient also presented with scalp and neck infection. Laboratory studies showed elevated total serum IgE level of 53,032 IU/mL and eosinophilia. Discussion : Ocular manifestations in HIES patients are not common. Some cases reported chalazia, keratoconus, and blepharitis. Surgical incision drainage was performed in our patient. Medications and surgical intervention had produced only transient improvement. The patient was treated conservatively. Riskof chalazia recurrence remains unknown as reported cases presented with diverse clinical presentation and follow-up serum IgE evaluation is not routinely performed. Conclusion : Recurrent multiple giant chalazia may occur as an ophthalmic feature of HIES. HIES should be considered and investigated in patients presenting with recurrent giant chalazia.