Pediatric Annals

Case Challenges 

An 11-year-old Male with Recurrent Orbital Swelling

Judith Ugale, MD; Chokechai Rongkavilit, MD

Abstract

An 11-year-old African American boy presented with four episodes of periorbital swelling. The first episode was characterized by 3 days of right periorbital swelling, blurring of vision, pain on eye movement, and frontal headache. Physical findings showed photophobia, right periorbital swelling, and conjunctival injection, with no limitation of extraocular movements or proptosis. Computed tomography (CT) showed extensive soft tissue swelling anterior to the right orbit with a post-septal, intraconal component surrounding the globe, opacification of the right ethmoid air cells and the right maxillary sinus, and mucosal thickening of the sphenoid sinus. He was started on intravenous ceftriaxone and clindamycin with a presumptive diagnosis of orbital cellulitis, and he improved.

ABOUT THE AUTHORS

Judith K. Ugale, MD, is Pediatric Resident, Wayne State University, Children’s Hospital of Michigan, Detroit. Chokechai Rongkavilit, MD, is Associate Professor, Pediatric Infectious Disease, Children’s Hospital of Michigan.

Address correspondence to: Judith K. Ugale, MD, 2354 Freedom Blvd., Unit 1-8, Florence, SC, 29505; or e-mail jmku2000@yahoo.com.

The authors have disclosed no relevant financial relationships.

The authors would like to acknowledge Dr. Mary Lieh-Lai for her assistance in editing this manuscript.

Abstract

An 11-year-old African American boy presented with four episodes of periorbital swelling. The first episode was characterized by 3 days of right periorbital swelling, blurring of vision, pain on eye movement, and frontal headache. Physical findings showed photophobia, right periorbital swelling, and conjunctival injection, with no limitation of extraocular movements or proptosis. Computed tomography (CT) showed extensive soft tissue swelling anterior to the right orbit with a post-septal, intraconal component surrounding the globe, opacification of the right ethmoid air cells and the right maxillary sinus, and mucosal thickening of the sphenoid sinus. He was started on intravenous ceftriaxone and clindamycin with a presumptive diagnosis of orbital cellulitis, and he improved.

ABOUT THE AUTHORS

Judith K. Ugale, MD, is Pediatric Resident, Wayne State University, Children’s Hospital of Michigan, Detroit. Chokechai Rongkavilit, MD, is Associate Professor, Pediatric Infectious Disease, Children’s Hospital of Michigan.

Address correspondence to: Judith K. Ugale, MD, 2354 Freedom Blvd., Unit 1-8, Florence, SC, 29505; or e-mail jmku2000@yahoo.com.

The authors have disclosed no relevant financial relationships.

The authors would like to acknowledge Dr. Mary Lieh-Lai for her assistance in editing this manuscript.

An 11-year-old African American boy presented with four episodes of periorbital swelling. The first episode was characterized by 3 days of right periorbital swelling, blurring of vision, pain on eye movement, and frontal headache. Physical findings showed photophobia, right periorbital swelling, and conjunctival injection, with no limitation of extraocular movements or proptosis. Computed tomography (CT) showed extensive soft tissue swelling anterior to the right orbit with a post-septal, intraconal component surrounding the globe, opacification of the right ethmoid air cells and the right maxillary sinus, and mucosal thickening of the sphenoid sinus. He was started on intravenous ceftriaxone and clindamycin with a presumptive diagnosis of orbital cellulitis, and he improved.

ABOUT THE AUTHORS

Judith K. Ugale, MD, is Pediatric Resident, Wayne State University, Children’s Hospital of Michigan, Detroit. Chokechai Rongkavilit, MD, is Associate Professor, Pediatric Infectious Disease, Children’s Hospital of Michigan.

Address correspondence to: Judith K. Ugale, MD, 2354 Freedom Blvd., Unit 1-8, Florence, SC, 29505; or e-mail jmku2000@yahoo.com.

The authors have disclosed no relevant financial relationships.

The authors would like to acknowledge Dr. Mary Lieh-Lai for her assistance in editing this manuscript.

10.3928/00904481-20080801-04

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