|Year : 1976 | Volume
| Issue : 4 | Page : 27-28
Salmonella lid abscess
SP Dhir1, IS Jain1, Praveen Kumar1, KC Aggarwal2, NK Ganguly2
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
S P Dhir
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh
Source of Support: None, Conflict of Interest: None
|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 Mar 18];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. 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|| |
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|| |
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|| |
A case of isolated chronic lid abscess with salmonella typhi in a young female is reported.
| References|| |
Duke Elder, S.. Text book of Ophthalmology, 5 p
5457, Henry Kimpton, London, 1955.
[Figure - 1]