Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. etnpiu noiu sntuulyse nteeebti omna ftehmnvgn n gut. and vagina human the of commensal a unsuspected is such with but possible eye are complications the unusual other in and infections seen eye usually COVID-19, with not However, is indolicus Peptoniphilus Background found was but biome, patient. gut our or Abstract vagina of the orbit of and outside sinus found the normally in not is indolicus Peptoniphilus Specifically, message clinical Key Support: Financial abscess orbital sinusitis, indolicus, Peptoniphilus COVID-19, article edited and Words wrote Key data, article Collected edited MPH: and MD, wrote Klug, data, Theodore Collected FACS: MD, Shires, B. Courtney Contributions Author [email protected] 38104 901-4911721 TN Germantown, Blvd, River Wolf 7945 Center Cancer West MPH MD, Klug, Theodore Author: Corresponding Patient Positive 1 FACS with COVID-19 MD, However, in Shires, Abscess B. Orbital gut. Courtney and and Sinusitis vagina Acute human of abscesses. Cause the orbital Unusual here of with presented occurrence commensal patient uncommon The a an bacteria. skin, is unsuspected the but with through possible eye bacteria are this the complications drained unusual in spontaneously other seen and infections usually eye not COVID-19, is indolicus Peptoniphilus Abstract 2020 23, August 1 Shires Courtney in Abscess Patient Orbital Positive and COVID-19 Sinusitis Acute of Cause Unusual etCne Center Cancer West etCne etr 95Wl ie ld emnon N38104 TN Germantown, Blvd, River Wolf 7945 Center, Cancer West 1 n hooeKlug Theodore and hspriua eerhrcie oitra retra rn funding. grant external or internal no received research particular This OI-9cnaettepeec fbcei ihncranaaoia regions. anatomical certain within bacteria of presence the affect can COVID-19 : 1 hooeKu,M,MPH MD, Klug, Theodore ; 1 1 1 Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. noiu,atp fbcei omlyfudi h aiaadstomach and vagina the in found Peptoniphilus normally patients. positive bacteria COVID-19 of in type reported been a have indolicus, manifestations and processes disease Rare intravenous of hemodynami- completion for deemed facility was nursing Discussion positive He his surgery. returned to 5-6). further back and (Figures intra- do transferred surgery eye was to of left during and antibiotics. plans days his stable taken no they several from neurologically had were drainage forceps, and completed and have Cultures cally cut He daily to Tru continued him pale. with When but evaluated indolicus. removed was hospitalization Otolaryngology Peptoniphilus were manipulated. the orbit and maxilla during when the antibiotics the bleed constellatus, of venous of not Streptococcus fat wall did MRSA, The medial mucosa avascularfor and The oddly bleed. turbinate was pale. not middle cavity but orbital did the nasal left edematous his of the surgery, was bone of During turbinate drainage the day. The with same Otolaryn- orbiotomy that 4). left the service underwent (Figure with Opthalmology also ethmoidectomy patient the anterior The with endoscopic day. abscess following and chest the removal, a service had infection. tissue endoscopic gology also COVID-19 reduction, with turbinate patient a antrostomy middle The with left maxillary endoscopic consistent itself. underwent left subsequently lung, globe margin and right the admitted inferior within the was the patient defect in cellulitis, The within open particularly was formation, an infiltrates, abscess be abscess patchy orbital to some periorbital the appeared showing and there of x-ray where margin orbital globe, The attack. left the ischemic 1-3). with of Type transient (Figures hypertension, sinusitis and osteomyelitis for showed cancer, extensive significant presentation testicular is and history ketoacidosis, upon and medical diabetic oriented past scan insulin, fully His CT not requiring drainage. was facility mellitus eye patient nursing the diabetes a the of from 2 presentation, history sent Upon a was provide but evaluation.” COVID-19 not ”psychiatric for could and positive drainage tested eye who left male white for 76-year-old a is gut. patient The and vagina human with the Presentation occurrence of uncommon Case an commensal skin, a the unsuspected through is such drained with abscesses. spontaneously but possible orbital here eye are presented complications patient the unusual The other in bacteria. and infections seen eye usually COVID-19, with not However, abscesses. patient’s is orbital Our indolicus for sinuses. rare Peptoniphilus infected is which acutely skin, in the found which through patient, typically Avascular, Background infected spontaneously tissue COVID-19 drain biome. edematous this to regions. gut and of began surgery anatomical or friable abscess during vagina the certain noted orbital the to was within cultures cavity contrast of bacteria nasal sinus in outside the of is patient’s of found presence bone the normally and the not mucosa presentation, affect pale is unusual can indolicus COVID-19 and Peptoniphilus that Specifically, COVID-19 notion with the infection support nursing concomitant the the to Given returned and antibiotics IV left of Conclusions and with days constellatus, sinusitis several showed Streptococcus on endoscopic scan MRSA, maintained underwent CT for was He home. positive He drainage. sent returned osteomyelitis. eye was indolicus. extensive Cultures was the patient Peptoniphilus and and orbiotomy. of the cellulitis, COVID-19 and history presentation, drainage formation, for Upon a transnasal abscess positive provide evaluation. periorbital tested not psychiatric and home and could orbital nursing drainage and eye a oriented left fully from for not male facility white nursing 76-year-old a from a is patient uncommon The an skin, the through Presentation bacteria Case this drained abscesses. spontaneously orbital here with presented occurrence patient The bacteria. 2 1 a on ihnorpatient’s our within found was , Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. epc o ofietaiyadpiaywr peddrn h td n t aiu nlssadinformation and analysis various its References and study the during upheld components. were assertation privacy and confidentiality for respect itself. study research the Consent during implemented and proposal and design Considerations: Ethical (ALI) ischemia limb Interest: acute of (BSI), tomography Conflicts infection Computed (COVID-19), bloodstream 2019 (DM), Disease mellitus Coronavirus orbital diabetes (MRSA), for (CT), aureus rare the staph also resistant of is Methicillin parts It other infections. Like Abbreviations COVID did. of of biome. abscess result List gut this a or as as vagina spontaneously, avascular the drain become Specifically, to of can regions. abscesses outside cavity anatomical support found sinonasal certain cultures within the normally patient’s bacteria body, not of the is presence presentation, the indolicus unusual affect Peptoniphilus can and COVID-19 COVID-19 that with our notion the in infection patient concomitant positive the COVID-19 Given patients the the in found of abscess six Conclusions orbital in of needed type was the abscess Kayhan of the by study. rarity study of the a drainage supporting from external example, further For patients, study adults. fourteen Oph- total the in of of ten drainage in age Academy abscess with the orbital American colleagues over to at the patients and looking antibiotics to in power intravenous high According infection with 78.6% with the conjunction as studies own. of high in its as resolution drainage to on complete surgical 20%, achieve drain recommend to abscess guidelines neuropathy 6.25% orbital from current optic varies thalmology, compressive an patients to pain does disease leading and sinus however, ab- compressed, among ophthalmoplegia, Rarely, orbital formation become proptosis, abscess spontaneously-draining can eye, of nerve the red dence optic of include the peculiarity presentations cases, the abscess standpoint. severe of vascular orbital a note Typical from made scess. specifically service patients, Ophthalmology positive the COVID-19 Finally, on patients surgery even nonatherosclerotic performing reported in when been and taken have therapy patients be anticoagulant COVID-19 receiving state in hypercoagulable complications those COVID- virus-related thromboembolic in was a surgeons the revascularization increased to the successful the during due and colleagues, noted to be and pandemic region to been peculiar COVID-19 believed Lombardy the have very expected, during Italian than fields and lower increased the surgical interest significantly avascular in ) significant adequately (ALI and evidenced of to ischemia ischemia as was order Limb in tissue pandemic, team nasal 19 case. care the the the of with of avascularity involved part the and a sinusitis note, be with Of also present should patients team COVID-19 organisms. Disease when unusual differential Infectious infec- cover their An polymicrobial to a abscess. it of orbital part add as therefore or should alone Physicians either available (BSI), choramnionitis bone infection become causing infections, bloodstream tion, fluid tissue causing amniotic Peptoniphilus soft from of and series Peptoniphilus skin infections discovered isolated diabetic site were also with surgical which sepsis and associated of seven infections, been genus, joint commonly the and most within have species species Peptoniphilus toniphilus 15 than 2012 more now in are There orbit. 2-9 nomdcnetwsotie ytesuyptet eecnewsmd o roiy and priority, top a made was beneficence patient, study the by obtained was consent Informed : tl,u ni o,nn fte1 pce aebe enwti h ri.T ae Pep- date, To orbit. the within seen been have species 15 the of none now, until up Still, . 27 eetees eoo h i ria bcse htnee riigdds spontaneously, so did draining needed that abscesses orbital six the of zero Nevertheless, . 15 ebleeta u aei h rtt ouetPpoihlswti h orbit. the within Peptoniphilus document to first the is case our that believe We . h uhr eotn eeatfiaca icoue eae oti urn work. current this to related disclosures financial relevant no report authors The l susrltdt tiswr ae nocnieaintruhu h study the throughout consideration into taken were ethics to related issues All 10-13 eetsuyo r-emlbraderyneonatal early and labor pre-term of study recent A . 3 16 nLmad,teicdneo ct limb acute of incidence the Lombardy, In . 16-19 14 16 ntr,peatosmust precautions turn, In . 26 nyrcnl i case a did recently Only . srpre ySilingardi by reported As . tl,teeaevr few very are there Still, . 21 h inci- The . 20-21 22-25 In . . Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. Cade R agnrne J tvnE.Teptoeei fobtlcmlctosi ct si- acute in complications orbital of pathogenesis The ER. Steven DJ, Langenbrunner TRIG- JR, CRICS Chandler X. 20. Delabranche young, M., two Ohana in I., ischaemia Leonard-Lorant limb F., Acute Severac A. C., Tacquard Freyrie J., M., Helms Azzarone patients: 3. C.B., COVID-19 19. Massoni in ischemia B., limb Nabulsi Acute P., pneu- N. Perini COVID-19 Leone 18. with T, patients Covic M, in Migliari ischemia S, limb Gennai Acute R, Silingardi al. 17. et report G, spp.: Natalini Peptoniphilus to L, due Luzzani infections R, Bloodstream D. Bellosta microbial Gregson 16. Comparative T, IA. Lynch D, Buhimschi Church YW, K, Brown Han V, 15. Bhandari using analysis S, ulcers an Temoin pressure bacteria: CS, anaerobic of to Buhimschi diversity due infections X, bacterial joint Wang and the Bone 14. of al. Evaluation et PO, Pinelli al. M, Vernier et G, Walter E, 13. Rees DE, Snow DM, within and Smith among diversity 12. bacterial the of Evaluation SE. Dowd Y, Sun dia- V, chronic Gontcharova of RD, Wolcott nature Polymicrobial 11. D. Rhoads E, Smith T, McKeehan Y, Sun RD, Wolcott SE, Dowd 10. Msr K uo ,Rbr ,Rol ,Fune E o otgosfiihdgnm sequence genome contiguous-finished Non description PE. Fournier and D, sequence Raoult genome C, contiguous-finished Robert Non P, Hugon al. AK, et Mishra JC, 6. Lagier P, of Hugon sequence AK, Genome Mishra al. et 5. A, Kang MY, Jung DS, Kim 4. UgrTpa ,Lwo A umnnP ’elL ieodSM. Finegold L, O’Neal P, Summanen PA, Lawson N, Ulger-Toprak 9. SM. Finegold S. C, Spring Liu P, Y, Song Schumann 8. R, Pukall JL, Swezey AP, Rooney 7. novel EJ. the Goldstein of KL, sequence Tyrrell genome nov., DM, Draft gen. Citron al. Anaerococcus et 3. genera HK, the Kim SN, of Park Proposal E, S. Cho Shu L, 2. Zhao ZY, Li N, Li Y, Kawamura T, Ezaki 1. n ecito of description and 2012;194:2405–2406. of Bacteriol. J specimens. clinical from isolated strain 2012;18:244–248. coccus Anaerobe. infections. clinical human from isolated nov. n eerhi ess.Hg iko hobssi ainswt eeeSR-o- neto:a infection: SARS-CoV-2 severe with 1970;80:1414–28. patients Laryngoscope. Evaluation in nusitis. Global 2020;46:1089–1098. thrombosis for Med. of Group Care Intensive risk Trial study. High Sepsis cohort and prospective Sepsis). multicenter Care in Intensive Research in Research and (Clinical Group GERSEP of ahead 2020;395:1546. online Lancet. COVID-19. [published with patients complications? non-atherosclerotic embolic of source 17]. the Jun be 2020 thrombus print, floating aortic 29]. Could Apr 2020 print, of ahead doi:10.1016/j.jvs.2020.04.483 online [published monia and birth preterm cases. by 15 print] complicated of of pregnancies ahead from [Epub 2013;8:e56131. blood ; One. 2014 cord PLoS Dis. and sepsis. Infect neonatal fluid Microbiol early-onset amniotic Clin paired J of Eur analysis literature. the of review and cases 61 of 2010;3:41. Genomics. Med BMC pyrosequencing pyrosequencing. amplicon bTEFAP titanium and 2009;9:226. FLX Microbiol. tag-encoded BMC approaches. bacterial metagenomic using and ulcers leg venous individual pyrosequencing amplicon FLX encoded 2008;3:e3326. tag One. bacterial using PLoS determined (bTEFAP) infections biofilm ulcer foot betic 2012;62:2336–2341. Microbiol. Micro- and Evol Syst J Int 2007;45:1746–1752. biol. beef. ground retail and from isolated coccus anaerobic 2011;61:1962–1967. biol. Gram-positive a nov., 2013;1(pii):e00822–13 Announc. Genome lesion. abscess periapical human Peptostreptococcus. a genus from the isolated of B134, members for nov. gen. Microbiol Gallicola Evol and Syst nov. gen. Peptoniphilus etnpiu bs sp obesi Peptoniphilus neoocsmrohisp murdochii Anaerococcus etnpiu oneeiesp koenoeneniae Peptoniphilus lnMcoilInfect Microbiol Clin etnpiu rsesssp grossensis Peptoniphilus 015(t4:5112.doi:10.1099/00207713-51-4-1521 4):1521-1528. 2001;51(Pt . acSurg Vasc J o.SadGnmcSi 2013;7:357–369. Sci. Genomic Stand nov. . o.ioae rmciia pcmn fhmnoii.JCi Micro- Clin J origin. human of specimens clinical from isolated nov. . etnpiu obci sp gorbachii Peptoniphilus 00S7151(03313 doi:10.1016/j.jvs.2020.06.008 2020;S0741-5214(20)31351-3. . 042(1:87O6.doi:10.1111/1469-0691.12657 2014;20(11):O857-O860. . o. sltdfo ua lnclseies n ytEvol Syst J Int specimens. clinical human from isolated nov., . etnpiu oi sp coxii Peptoniphilus o.SadGnmcSi 2012;7:320–330. Sci. Genomic Stand nov. . 4 etnpiu rhinitidis Peptoniphilus acSurg Vasc J nov., . o.and nov. . etnpiu ehoiioa sp methioninivorax Peptoniphilus etnpiu lei sp olsenii Peptoniphilus etnpiu urei sp duerdenii Peptoniphilus etnpiu sp Peptoniphilus 2020;S0741-5214(20)31080-6. . etnpiu yrliesp tyrrelliae Peptoniphilus -3,a anaerobic an 1-13T, tanChDC strain . nov., . nov. . n J Int . . Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. tr etmxlayo.Fgr .Obtlasesdang y pn iue6 ria bcs riae– drainage abscess Orbital turbinate, 6. middle Figure left open. Diamond- eye – meatus. drainage middle abscess left Orbital the 5. of closed. Figure tissue eye os. avascular maxillary of left view Star- Endoscopic 4. Figure CT. Sinus Sagittal 3. Figure CT. Sinus Coronal 2. Figure CT. sinus Axial 1. Figure Legend Figure iue1 xa iu CT. sinus Axial 1. Figure Kya T ai ,Yzc M ru .Mngmn fobtlsbeiselabscess. subperiosteal orbital of Management O. Erdur ZM, Yazici I, Sayin FT, Kayhan cellulitis. 27. orbital orbit: children. hot 26. The in YO. sinusitis Arat acute W, of Al-Rashed IA, complications Chaudhry Orbital sinusitis. 25. DO. Mikaelian ethmoid diseases. SA, Scherr sinus and JB, of Giletto frontal complications 24. Orbital of JJ. infections Welsh Complications orbital LW, of Welsh WV. diagnosis 23. pathological Morrison in Update PR, M. Yanoff Morgan J, 22. Biswas HK, Yuen VB, Choi Lam 21. Surg Ophthalmology doi:10.4103/0974-9233.92114. 2012;19(1):34-42. . Otolaryngol Ophthalmol Acad doi:10.1288/00005537-197405000-00015 doi:10.1288/00005537-198004000-00013 1980;90(4):661-666. inflammations. and 002()11-17 doi:10.1097/SCS.0b013e3181e1b50d 2010;21(4):1114-1117. . : 2000;107:1454–1458 ideEs f Ophthalmol J Afr East Middle 1981;34(1):60-64. . 5 011()2826 doi:10.4103/0974-9233.90127 2011;18(4):268-276. . Laryngoscope ideEs f Ophthalmol J Afr East Middle 1974;84(5):848-856. . Laryngoscope Craniofac J rn Pa Trans . Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. iue3 aitlSnsCT. Sinus Sagittal 3. Figure CT. Sinus Coronal 2. Figure 6 Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. iue5 ria bcs riae–eeopen. eye – drainage abscess Orbital 5. Figure turbinate, middle left Diamond- meatus. middle left the of tissue os. avascular maxillary of left view Star- Endoscopic 4. Figure 7 Posted on Authorea 23 Aug 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159818381.18521272 — This a preprint and has not been peer reviewed. Data may be preliminary. iue6 ria bcs riae–eeclosed. eye – drainage abscess Orbital 6. Figure 8