Peer Review Report For: Case Report: Orbital cellulitis with panophthalmitis during pregnancy: a rare case in Bangladesh [version 2; peer review: 1 approved, 2 not approved]

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Background It is uncommon to develop vision-threatening orbital cellulitis with panophthalmitis during pregnancy. Typically, the reasons are trauma-related or endogenous. It requires immediate diagnosis and treatment, but this has proven difficult because of local and systemic medications’ safety and adverse effects during pregnancy. Globe salvage has a poor prognosis, with most patients undergoing enucleation or evisceration of the diseased eye. Case presentation We presented a 22-year-old woman in her third trimester of pregnancy who encountered orbital cellulitis with panophthalmitis caused by methicillin-positive Staphylococcus aureus (MSSA). Despite rigorous intravenous and topical antibiotics, she underwent evisceration of the affected eye. However, the pregnancy, progressed without incident, with the delivery of a healthy baby at full-term. Conclusion Bacterial infection is uncommon during pregnancy, but may cause endogenous panophthalmitis and orbital cellulitis, especially in immunosuppression and anemia, with a poor visual outcome.