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Ethmoidal mucocele causing proptosis in a pediatric patient with cystic fibrosis: A case report

Published:March 01, 2022DOI:https://doi.org/10.1016/j.jcf.2022.02.016

      Highlights

      • Prevalence of Ear Nose Throat pathology in Cystic Fibrosis patients is high but often remains undiagnosed.
      • A close Ear Nose Throat follow up is strongly recommended to prevent possible complications in Cystic Fibrosis patients.
      • Ethmoidal mucocele is not a common Ear Nose Throat complication but it is important because it could result in severe visual impairment.
      • Recent studies have shown phenotypical changes in Escherichia coli strains that remembered those of the classic Cystic Fibrosis pathogens and association between Escherichia coli and Ear Nose Throat pathology.

      Abstract

      In cystic fibrosis (CF) patients, Ear Nose Throat (ENT) pathology is often undiagnosed despite its high prevalence and its possible life-threatening complications. We present the case of an ethmoidal mucocele leading to ocular manifestations in a 2-year-old girl with cystic fibrosis with no previous serious complications. She progressively developed non-axial proptosis, limitation of the adduction and exotropia of her left eye. Paranasal sinus magnetic resonance image (MRI) showed a left ethmoidal mucocele causing displacement of the ocular globe, compression of the medial rectus and the optic nerve. Eye fundus revealed disc edema and diffuse vascular congestion. Endoscopic sinus surgery was performed to remove the mass. The mucocele was drained and the discharge was sent for microbiology assessment. Escherichia coli (E. coli) was found in the culture and treated with cefotaxime and dexamethasone with complete resolution of non-axial proptosis and disc edema.

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