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   Table of Contents      
ARTICLES
Year : 1976  |  Volume : 24  |  Issue : 4  |  Page : 27-28

Salmonella lid abscess


1 Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
S P Dhir
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


PMID: 924617

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How to cite this article:
Dhir S P, Jain I S, Kumar P, Aggarwal K C, Ganguly N K. Salmonella lid abscess. Indian J Ophthalmol 1976;24:27-8

How to cite this URL:
Dhir S P, Jain I S, Kumar P, Aggarwal K C, Ganguly N K. Salmonella lid abscess. Indian J Ophthalmol [serial online] 1976 [cited 2019 May 20];24:27-8. Available from: http://www.ijo.in/text.asp?1976/24/4/27/31279

Occasionally chronic orbital abscess has been noted alongwith multiple abscesses throughout the body during the course of fever[1]. Isolated abscess of the eyelid following typhoid fever is rare. We came across a patient with isolated chronic lid abscess with Salmonella typhi organism which is being reported.


  Case Report Top


R.K. 23 F presented with complaints of swelling and pain over the left upper eyelid for the past three months. Patient gave a history of typhoid fever 15 days prior to the onset of eyelid swelling. She was treated with chlo­romycetine capsules. After the subsidence of fever she developed swelling and pain in the left upper lid. She was treated with injection and tablets by a local practitio­ner. Pain subsided but swelling persisted.

On examination left palpebral aperture was narrow and there was fullness of the left upper lid in the lateral half. An oval granular mass lxl.5 cms could be pal­pated [Figure - 1]. The skin overlying the swelling was crusted but temperature was not raised. The mass did not empty on pressure and was non-tender. Orbital margin was intact. Prolapsed lacrimal gland could be seen in the fornix. X-rays of the orbit did not reveal any bony lesion. Aspiration of the mass through the skin with a thick needle was carried out. One ml. of whitish creamy pus was removed which on culture yiel­ded Salmonella typhi. Two days later another aspira­tion was carried out which also yielded Salmonella typhi.

Blood test for Widal revealed the following titres T. H. 1/20, TO 12/0,AO 1/20 and Vi 1/40.

Patient was treated with a course of chloromycetine (250 mg. QID for 3 weeks) and became well. She had another recurrence at the same site after 2 years. Aspi­ration of pus again yielded Salmonella typhi. Repeated urine and stool cultures for Salmonella typhi were nega­tive. Blood test for Widal revealed titres of TH 1/40, TO 1/80, AO 1/20, and Vi 1/20. Patient was prescribed a course of ampicillin. (1G daily for 2 months). She has been well for the past 6 months.


  Comments Top


The lid swelling provisionally diagnosed as lacrimal retention cyst later on turned out to be a salmonella abscess. Clinically all signs of acute inflammation usually seen with an abscess were absent.

Patient suffered from an attack of typhoid fever and became typhoid carrier as supported by significant vi agglutinins as against normal levels of flageller (H) and somatic (0) agglu­tinins. Typhoid bacilli are known to lodge in bones especially the flat bones, vertebrae and the orbital bones giving rise to acute or chronic osteomyelitis. Patient develops multi­ple abscesses over the body and diagnosis under such a situation is easy. However, in case of an isolated abscess, diagnosis is rather difficult. In addition in this patient no radio­logical evidence of osteomyelitis of the orbital bones could be detected.


  Summary Top


A case of isolated chronic lid abscess with salmonella typhi in a young female is reported.

 
  References Top

1.
Duke Elder, S.. Text book of Ophthalmology, 5 p 5457, Henry Kimpton, London, 1955.  Back to cited text no. 1
    


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