Rajalekshmi P S, Evans Sarah L, Morton Claire E, Williams Richard E A, Ng C S
Department of Ophthalmology, H. M. Stanley Hospital, St. Asaph, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2003 May;19(3):244-6. doi: 10.1097/01.iop.0000064989.80844.b8.
A 4-year-old girl had redness and swelling of the left upper eyelid of 1 week's duration. She had been treated with topical fusidic add and oral flucloxacillin without resolution. Ophthalmic examination showed a diffuse, erythematous, tender lesion affecting the entire upper eyelid. There was a central area of skin ulceration with marked bleeding and discharge. Also found were small vesicles under the left eyebrow. The child's mother had noticed a scaly rash on her own forearm. Examination under anesthesia was carried out to assess the globe and to obtain samples for microbiology investigation. Microbiology scrapings showed fungal hyphae of the Dermatophyte group. Treatment with Griseofulvin was commenced, and complete resolution of the lesion occurred. To our knowledge there is only one similar case reported in the literature describing ring-worm as a cause of preseptal cellulitis. This case highlights the importance of considering alternative diagnoses when standard antibiotic treatment has failed.
一名4岁女孩左上眼睑红肿已有1周时间。她曾接受过局部夫西地酸和口服氟氯西林治疗，但症状未缓解。眼科检查显示，整个上眼睑有弥漫性、红斑性、压痛性病变。有一个中央皮肤溃疡区域，伴有明显出血和分泌物。在左眉下方还发现了小水疱。患儿母亲注意到自己前臂有鳞屑性皮疹。在麻醉下进行检查以评估眼球并获取微生物学调查样本。微生物学刮片显示为皮肤癣菌属的真菌菌丝。开始使用灰黄霉素治疗，病变完全消退。据我们所知，文献中仅报道过1例类似病例，将癣描述为眶隔前蜂窝织炎的病因。该病例凸显了在标准抗生素治疗失败时考虑其他诊断的重要性。
