Periorbital and orbital cellulitis (pediatrics) Quiz: Ace Your Exams
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A 4-year-old boy is brought to the emergency department by his parent for evaluation of right eye pain and swelling for one week. The parent reports the patient has been vigorously rubbing his eye stating, “It hurts.” The week before he had nasal congestion and rhinorrhea. The patient has no significant medical history. Temperature is 37.5°C (99.5°F), blood pressure is 106/62 mmHg, pulse is 102/min, respiratory rate is 22/min, and oxygen saturation is 99% on room air. On physical examination, the pupils are equal and reactive bilaterally. There is soft tissue swelling, erythema, and tenderness about the right orbit. The patient has difficulty opening the eye. The left eye is within normal limits. There is nasal congestion. Cardiopulmonary examination is within normal limits. Which of the following would indicate this patient should be treated as an inpatient with intravenous antibiotics?
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