Acute orbital myositis: case report

Bittar, Mirian S.; Garcia, Maria L.; Marchiori, Paulo E.

doi:10.1590/S0004-282X1997000100022

Abstracts

The case of 22-year old, white woman with bilateral orbital myositis following an acute upper respiratory tract infection is reported. The most important clinical findings were ocular pain, proptosis, restricted eye motility and swelling of the eyelids. The enlarged eye muscles were seen on orbital computerized tomography scan. The clinical findings of inflammatory orbital myositis and clinical response to corticotherapy are emphasized.

acute orbital myositis; inflammation; computerized tomography scan

Os autores relatam o caso de uma paciente, com 22 anos de idade, branca, com infecção viral das vias aéreas superiores há 2 semanas e há cinco dias com cefaléia frontal intensa, edema bipalpebral assimétrico, olho avermelhado, fotofobia, diplopia e dor à movimentação lateral dos olhos. Os exames laboratoriais somente revelaram discreta elevação da velocidade de hemossedimentação; a avaliação hormonal e imunológica de disfunção da tireóide nada revelou; o estudo da imagem por tomografia computadorizada craniana mostrou presença de sinusopatia etmoidal, espessamento e imagem densa dos músculos reto interno e oblíquo superior esquerdos e do reto lateral direito. Foi feito o diagnóstico de miosite aguda orbitáría. A paciente foi submetida a terapêutica com corticosteróide (prednisona 60 mg/dia), com rápida e eficiente melhora clínica. Os autores salientam os diagnósticos diferenciais chamam a atenção para a raridade da doença e sua possível etiologia viral.

miosite aguda orbitáría; inflamação; tomografia computadorizada

Acute orbital myositis: case report

Miosite aguda orbitáría: relato de caso

Mirian S. Bittar^I; Maria L Garcia^II; Paulo E. Marchiori^III

^INeurologic Clinic and General Internal Medicine Clinic of São Paulo University. School of Medicine, São Paulo: Fellow of Neurologic Clinic

^IINeurologic Clinic and General Internal Medicine Clinic of São Paulo University. School of Medicine, São Paulo: Assistant of Internal Medicine

^IIINeurologic Clinic and General Internal Medicine Clinic of São Paulo University. School of Medicine, São Paulo: Associate Professor of Neurologic Clinic

ABSTRACT

The case of 22-year old, white woman with bilateral orbital myositis following an acute upper respiratory tract infection is reported. The most important clinical findings were ocular pain, proptosis, restricted eye motility and swelling of the eyelids. The enlarged eye muscles were seen on orbital computerized tomography scan. The clinical findings of inflammatory orbital myositis and clinical response to corticotherapy are emphasized.

Key words: acute orbital myositis, inflammation, computerized tomography scan.

RESUMO

Os autores relatam o caso de uma paciente, com 22 anos de idade, branca, com infecção viral das vias aéreas superiores há 2 semanas e há cinco dias com cefaléia frontal intensa, edema bipalpebral assimétrico, olho avermelhado, fotofobia, diplopia e dor à movimentação lateral dos olhos. Os exames laboratoriais somente revelaram discreta elevação da velocidade de hemossedimentação; a avaliação hormonal e imunológica de disfunção da tireóide nada revelou; o estudo da imagem por tomografia computadorizada craniana mostrou presença de sinusopatia etmoidal, espessamento e imagem densa dos músculos reto interno e oblíquo superior esquerdos e do reto lateral direito. Foi feito o diagnóstico de miosite aguda orbitáría. A paciente foi submetida a terapêutica com corticosteróide (prednisona 60 mg/dia), com rápida e eficiente melhora clínica. Os autores salientam os diagnósticos diferenciais chamam a atenção para a raridade da doença e sua possível etiologia viral.

Palavras-chave: miosite aguda orbitáría, inflamação, tomografia computadorizada.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aceite: 23-outubro-1996.

Dr. Paulo E. Marchiori - Clínica Neurológica, Hospital das Clínicas, FMUSP - Avenida Dr. Enéas de Carvalho Aguiar 255, 5º andar - 05403-000 São Paulo SP - Brasil.

1. Bach MC, Michael K, Scheyler WBJ. Acute orbital myositis mimicking orbital cellulitis. Ann Intern Med 1988; 109:243-245.
2. Barnes C. Orbital myositis: a case report. Aust NZ Ophtalmol 1990;18:251-255.
3. Costeels I, De Bleecker C, Demaerel P, Van Wilderode W, Missottenl, Wilms G, Baert AL. Orbital myositis following an upper respiratory tract infection: contribution of high resolution CT and MRI. J Beige Radiol 1991;74:45-47.
4. Dresner SC, Rothfus WE, Slamovitis TL, Kennerdell JS, Curtin HD. Computerized tomography of orbital myositis. AJR 1984;143:671-674.
5. Dua HS, Smith FW, Singh AK, Forrester JV. Diagnosis of orbital myositis by nuclear magnetic resonance imaginf. Br J Ophthalmol 1987;71:54-57.
6. Fries PD, Fohrman DS, Char DH. Phorbol ester-induced orbital myositis. Arch Ophthalmol 1987;105:1273-1276.
7. Hankey GJ, Libbert PL, Edis RH, Nicoel AM. Orbital myositis: a study of six cases. Aust Med 1987;17:585-591.
8. Lahoud S, Bownstein S, Barown-Homsy M. Inferior oblique myositis presenting as superior oblique muscle palsy. Can J Ophthalmol 1988;23:124-127.
9. Lockie P. Acute orbital myositis: a case report. Aust NZ J Ophthalmol 1985;13:287-291.
10. Lin SH, Prendergast RA, Silverstein AM. Experimental immunogenic granuloma of the orbit: transfer of granulomatous hypersensitivity with a subset of T lymphocytes. Invest Ophthalmol Vis Sci 1986;27:70-76
11. Mastaglia FL, Ojeda VJ. Inflammatory myophaties. Part 1. Ann Neurol 1985,17:215-227.
12. Noble AG, Tripathi RC, Levine RA. Indomethacin for the treatment of idiophatic orbital myositis. Am J Ophthalmol 1989;108:336-338.
13. Orssaud C, Poisson M, Gardeur D. Orbital myositis, recurrence of Whipple's disease. J Fr Ophthalmol 1992;15:205-208.
14. Reifler DM, Leder D, Rexford T. Orbital hemorrhage and eyelid ecchymosis in acute orbital myositis. Am J Ophthalmol 1989;107:111-113.
15. Rohr J, Gauthier G. Acute idiophatic orbital myositis. Rev Neurol 1988;144:47-48.
16. Sanchez-Roman J, Varela-Aguiar JM, Bravo-Ferrer j, Sequeiros ME, Fernandez de Bobadilla M. Idiopathic orbital myositis, treatment with cyclosporin-A (Letter). Ann Rheum Dis 1993;52:84-85.
17. Seindenberg KB, Leib ML. Orbital myositis with Lyme disease. Am J Ophthalmol 1990; 109:13-16.
18. Shah SS, Lowder CJ, Schmith MA, Wilke WS, Kormorsky GS, Meisler DM. Low dose methotrexate therapy for ocular inflammatory disease. Ophthalmology 1992;99:1419-1423.
19. Wan WL, Cono MR, Green RL. Orbital myositis involving the oblique muscles: an echographic study. Ophthalmology 1988;95:1522-1528.

Publication Dates

Publication in this collection
10 Nov 2010
Date of issue
1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bach MC, Michael K, Scheyler WBJ. Acute orbital myositis mimicking orbital cellulitis. Ann Intern Med 1988; 109:243-245.

[2] 2. Barnes C. Orbital myositis: a case report. Aust NZ Ophtalmol 1990;18:251-255.

[3] 3. Costeels I, De Bleecker C, Demaerel P, Van Wilderode W, Missottenl, Wilms G, Baert AL. Orbital myositis following an upper respiratory tract infection: contribution of high resolution CT and MRI. J Beige Radiol 1991;74:45-47.

[4] 4. Dresner SC, Rothfus WE, Slamovitis TL, Kennerdell JS, Curtin HD. Computerized tomography of orbital myositis. AJR 1984;143:671-674.

[5] 5. Dua HS, Smith FW, Singh AK, Forrester JV. Diagnosis of orbital myositis by nuclear magnetic resonance imaginf. Br J Ophthalmol 1987;71:54-57.

[6] 6. Fries PD, Fohrman DS, Char DH. Phorbol ester-induced orbital myositis. Arch Ophthalmol 1987;105:1273-1276.

[7] 7. Hankey GJ, Libbert PL, Edis RH, Nicoel AM. Orbital myositis: a study of six cases. Aust Med 1987;17:585-591.

[8] 8. Lahoud S, Bownstein S, Barown-Homsy M. Inferior oblique myositis presenting as superior oblique muscle palsy. Can J Ophthalmol 1988;23:124-127.

[9] 9. Lockie P. Acute orbital myositis: a case report. Aust NZ J Ophthalmol 1985;13:287-291.

[10] 10. Lin SH, Prendergast RA, Silverstein AM. Experimental immunogenic granuloma of the orbit: transfer of granulomatous hypersensitivity with a subset of T lymphocytes. Invest Ophthalmol Vis Sci 1986;27:70-76

[11] 11. Mastaglia FL, Ojeda VJ. Inflammatory myophaties. Part 1. Ann Neurol 1985,17:215-227.

[12] 12. Noble AG, Tripathi RC, Levine RA. Indomethacin for the treatment of idiophatic orbital myositis. Am J Ophthalmol 1989;108:336-338.

[13] 13. Orssaud C, Poisson M, Gardeur D. Orbital myositis, recurrence of Whipple's disease. J Fr Ophthalmol 1992;15:205-208.

[14] 14. Reifler DM, Leder D, Rexford T. Orbital hemorrhage and eyelid ecchymosis in acute orbital myositis. Am J Ophthalmol 1989;107:111-113.

[15] 15. Rohr J, Gauthier G. Acute idiophatic orbital myositis. Rev Neurol 1988;144:47-48.

[16] 16. Sanchez-Roman J, Varela-Aguiar JM, Bravo-Ferrer j, Sequeiros ME, Fernandez de Bobadilla M. Idiopathic orbital myositis, treatment with cyclosporin-A (Letter). Ann Rheum Dis 1993;52:84-85.

[17] 17. Seindenberg KB, Leib ML. Orbital myositis with Lyme disease. Am J Ophthalmol 1990; 109:13-16.

[18] 18. Shah SS, Lowder CJ, Schmith MA, Wilke WS, Kormorsky GS, Meisler DM. Low dose methotrexate therapy for ocular inflammatory disease. Ophthalmology 1992;99:1419-1423.

[19] 19. Wan WL, Cono MR, Green RL. Orbital myositis involving the oblique muscles: an echographic study. Ophthalmology 1988;95:1522-1528.