Orbital Cellulitis-When Computed Tomography Imaging Is Falsely Reassuring.

Pediatric Emergency Care
Arsany BasilyPeter Gutierrez

Abstract

An 8-year-old male presented to the pediatric emergency department with subjective fever, blurry vision, and left eye pain. On physical examination, there was mild left lower lid erythema and a subtle left eye elevation deficit. Computed tomography demonstrated preseptal soft tissue swelling without orbital involvement; however, there was varying amounts of paranasal sinus opacification. Despite the negative scan, a diagnosis of orbital cellulitis associated with sinusitis was made and treatment with intravenous antibiotics was initiated. A magnetic resonance imaging performed subsequently revealed orbital fat stranding and inferior rectus enlargement and enhancement near the orbital apex, indicating the presence of orbital cellulitis. This case demonstrates the utility of magnetic resonance imaging when initial computed tomography imaging is negative in patients with concern for orbital cellulitis.

References

Sep 1, 1970·The Laryngoscope·J R ChandlerE R Stevens
Oct 6, 2001·Current Opinion in Ophthalmology·J L Tovilla-CanalesJ L Tovilla y Pomar
Mar 3, 2010·Pediatrics·Tiffany F RudloeAmir A Kimia
Oct 26, 2010·The Journal of Pediatrics·Veronica K GoytiaMorven S Edwards
Aug 17, 2011·Archives of Otolaryngology--head & Neck Surgery·Aditya Mahalingam-DhingraRahul K Shah

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