rss
Emerg Med J 2006;23:e66 doi:10.1136/emj.2006.041194
  • Emergency casebook

An eye for trouble: orbital cellulitis

  1. P A R Armstrong,
  2. N M Nichol
  1. Emergency Department, Ninewells Hospital, Dundee, UK
  1. Correspondence to:
 P Armstrong
 Emergency Department, Ninewells Hospital, Dundee DD1 9SY, UK; peter.armstrong{at}nhs.net
  • Accepted 15 August 2006

Abstract

Patients with orbital cellulitis present to emergency departments occasionally. Symptoms usually develop rapidly, with patients being distressed by painful ocular movements and systemic upset. The case of a 24-year-old man who had a 1-month gradual history of intermittent periorbital swelling after a flu-like illness, and subsequently developed a large intracranial extradural abscess eroding through the temporal bone, ultimately requiring neurosurgical intervention is presented.

Although orbital and periorbital swelling is common after acute sinusitis, cellulitis and intracranial abscess are rare but potentially life threatening and sight threatening. Accurate diagnosis is therefore of great importance.

In this case, the patient presented with few clinical signs but relevant pathology. The importance of assessing ocular movement, which is a major clinical abnormality indicating orbital disorder and thus an aid to accurate diagnosis, should be highlighted.

Footnotes

  • Competing interests: None.

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.