Novel use of positron emission tomography/computed tomography in the diagnosis of infected porous orbital implant

摘要

We report the use of positron emission tomography/ computed tomography (PET/CT) in the diagnosis of orbital implant infection.A 74-year-old lady presented with a 6-month history of recurrent purulent discharge from her right socket. She has a secondary orbital implant; a 20-mm Vicryl Mesh-Wrapped Aluminum Oxide Implant (FCI Ophthalmics, Marshfield Hills, MA, USA) inserted 9 months earlier. This was complicated with an early pyogenic granuloma that required cautery. Her primary evisceration was performed 50 years ago in Iran for a painful blind eye secondary to penetrating eye injury. On her initial presentation, there was discharge, ocular discomfort but no bleeding. She was systemically well and did not have any comorbidities. On examination, there was mucopurulent discharge, papillary conjunctival inflammation and a central granuloma without implant exposure. Culture of the discharge grew pan-sensitive Pseudomonas aeruginosa and she was managed as chronic conjunctivitis. Over the duration of 3 months, she failed to respond to prolonged courses of various combinations of antibiotics (Tazocin, Ciprofloxacin, Gentami-cin and Chloramphenicol), topical corticosteroids (Hydrocortisone) and topical antiseptic (Iodine).