Ophthalmology, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
Ophthalmology, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India.
BMJ Case Rep. 2021 Feb 1;14(2):e237487. doi: 10.1136/bcr-2020-237487.
A 10-year-old child had painful periorbital swelling in the left eye. It was diagnosed as preseptal cellulitis and treated with oral antibiotics. Three days later, the ocular condition worsened so the child was referred for further management. On examination, the child had a temperature of 102 °F. Ocular examination revealed proptosis, restricted ocular movements and a relative afferent pupillary defect in the left eye. Ocular examination of the right eye was normal. There was a history of recurrent episodes of cold in the past. CT scan orbit and sinuses revealed signs of orbital cellulitis with sinusitis on the left side. The child was treated with parenteral antibiotics and endoscopic sinus surgery. A child presenting with unilateral periorbital swelling needs to be thoroughly evaluated. It is important to differentiate orbital cellulitis from preseptal cellulitis. Orbital cellulitis is an emergency and delay in diagnosis can lead to vision and life-threatening intracranial complications.
一位 10 岁儿童左眼出现疼痛性眶周肿胀。诊断为眶前部蜂窝织炎，给予口服抗生素治疗。3 天后，眼部病情恶化，遂转至其他医疗机构进一步治疗。检查发现患儿体温为 102°F。眼部检查显示左眼眼球突出、眼球运动受限和相对性传入性瞳孔障碍。右眼眼部检查正常。患儿过去常有反复发作的感冒病史。眼眶和鼻窦 CT 扫描显示左侧眶蜂窝织炎和鼻窦炎的迹象。患儿接受了静脉注射抗生素和鼻内镜鼻窦手术治疗。单侧眶周肿胀的患儿需要进行全面评估。重要的是要区分眶蜂窝织炎和眶前部蜂窝织炎。眶蜂窝织炎是一种急症，诊断延误可导致视力丧失和危及生命的颅内并发症。
