سياه زخم: علتي نادر براي سلوليت پري اوربيتال و اكتروپيون سيكاتريسي

Anthrax: A Rare Cause of Periorbital Cellulitis and Cicatricial Ectropion

Introduction: Among the three human forms of anthrax: (cutaneous, inhalational, and gastrointestinal), the cutaneous form is the most common disease (95%). Cutaneous anthrax is a rare cause of periorbital (preseptal) cellulitis, therefore, diagnosis and initiation of treatment may be delayed. On the other hand, without correct diagnosis and appropriate treatment, periorbital anthrax may result in sever local complications such as blindness and airway obstruction, or dissemination of the disease like bacteremia and meningitis. In this research was introduced a child with periorbital anthrax to present the clinical manifestation and progression of the disease and remind physicians to interest contagious cause of periorbital cellulitis. Case Report: A 2.5 years old boy from a rural area of Guilan who was suffered of a small erythematous papule in his right lower eyelid 5 days prior to admission. Then, the lesion progressed to a necrotic ulcer with a black central eschar, edema and erythema at the area around. Sever swelling of eyelids and edema occurred all over the face. Fever wasnʹt observed. The child had repetitious contacts with domestic herbivores. CT scan of the orbit and paranasal sinuses showed soft tissue swelling only. Gram-positive rods were seen in the smear of exudate taken from cutaneous lesion but culture result showed negative. Treatment with intravenous ciprofloxacin, penicillin, and clindamycin resulted in clinical improvement but due to cicatricial ectropion formation, oculoplastic intervention was considered to be done. Conclusion: Physicians must consider it to be anthrax ifany of the following symbols exists: a history of contact with domestic herbivores and animals, similar lesions in the family members. cutaneous necrotic ulcer with the characteristic black eschar and edema of the area around, and observing Gram-positive rods in scraped material taken from beneath the eschar edge or exudate of cutaneous lesions. Although anthrax of the eyelids is not common disease, it must be consider as in the differential diagnosis of periorbital cellulitis.