Purpose: To report a series of 7 cases of orbital abscess with unusual features that may mimic other cystic orbital lesions.
Methods: Retrospective study of all cases of orbital cellulitis/abscess treated at our center, over 1 year, highlighting cases with unusual features.
Results: Thirty-one cases were studied, where orbital cellulitis/abscess was the final diagnosis. Of these, 7 patients did not have typical signs and/or symptoms of local infection. At presentation, there was no associated predisposing risk factor, indicating the source of infection. The duration of symptoms, among these 7 patients, ranged from 3 weeks to 6 months. The initial diagnosis was myocysticercosis in 3 cases, orbital dermoid in 1 case, lymphangioma in 1 case, pseudotumor in 1 case, and schwannoma in 1 case.
Conclusions: Unusual presentations of orbital abscess can mimic other conditions of the orbit. Orbital abscess should be considered in the differential diagnosis if a cystic lesion has not responded or partly responded to systemic antibiotics and there are associated signs or symptoms of intermittent or constant low-grade inflammation, even in the absence of predisposing risk factors.