title: A case of orbital apex syndrome in a patient with malignant otitis externa.
abstract: A rare case of skull base infection with a rapid clinical course leading to visual loss and eventually death in a poorly-controlled diabetic patient is presented. A 37-year-old woman presented with a history of visual loss and painful protrusion of the right eye for the preceding 3 days.This was accompanied by vertigo and right-side facial weakness. The patient had perception of light in her right eye and 20/25 (presenting visual acuity) in the fellow eye, accompanied by right-side proptosis, total ophthalmoplegia, optic disc pallor and central retinal artery occlusion. Magnetic resonance imaging showed the presence of oedema with soft-tissue thickening in the right external auditory canal along with evidence of fluid within the middle ear cavity and mastoid air cells on the right side. A diagnosis of Orbital Apex Syndrome was made and treatment initiated.
authors.affiliation: Sections of Ophthalmology and Otolaryngology, Department of Surgery, Aga Khan University, Karachi. rashid.baig@aku.edu
authors.forename: Rashid
authors.initials: R
authors.lastname: Baig
authors.forename: Qazi Assad
authors.initials: QA
authors.lastname: Khan
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sadiq
authors.forename: Sohail
authors.initials: S
authors.lastname: Awan
authors.forename: Khabir
authors.initials: K
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D005094:Exophthalmos / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D008279:Magnetic Resonance Imaging; D009886:Ophthalmoplegia / Q000209:etiology*; D010032:Otitis Externa / Q000150:complications* / Q000188:drug therapy; D013577:Syndrome; D014786:Vision Disorders / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents