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Orbital subperiosteal abscess

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Remarkable left side eyelids swelling and reddening, proptosis, pain, and fever.

Patient Data

Age: 5 years
Gender: Female

There are remarkable fluid and mucosal thickening in the left side frontal, ethmoid, maxillary, and sphenoid sinuses with sinus cavities obliteration and ovoid shape subperiosteal fluid-soft tissue density in left orbital nasal side extraconal with impression on related medial rectus muscle and largely extended within the superior oblique muscle. Remarkable left side proptosis and preseptal and eyelids inflammatory change and swelling are also seen. 

Case Discussion

The case is a 5-year-old girl who came to the emergency room due to remarkable left side eyelids swelling and pain and fever. The non-contrast MDCT requested and left orbital subperiosteal abscess as a major complication of bacterial sinusitis in children detected. The orbital subperiosteal abscess can be life-threatening and progress to intracranial infection and blindness and prompt diagnosis and treatment are necessary. The treatment can be medical therapy and/or surgical drainage.

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