A 13-Year-Old Male With Left Eye Swelling

Author:

Nazari Matthew A.12,Rosenblum Jared S.3,Zhuang Zhengping34,Malik Archana5,Lonser Russell R.6,Pacak Karel2,Aronoff Stephen78

Affiliation:

1. aDepartment of Internal Medicine and Pediatrics, Georgetown University Hospital, Washington, District of Columbia

2. bSection on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

3. cNeuro-Oncology Branch, National Cancer Institute

4. dSurgical Neurology Branch, National Institute of Neurologic Disorders and Stroke, National Institutes of Health, Bethesda, Maryland

5. eDepartment of Pediatric Diagnostic Radiology, St. Christopher’s Hospital for Children, Philadelphia, Pennsylvania

6. fDepartment of Neurologic Surgery, Ohio State University, Wexner Medical Center, Columbus, Ohio

7. gDepartment of Pediatrics, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania

8. hSection of Pediatric Infectious Diseases, St. Christopher’s Hospital for Children, Philadelphia, Pennsylvania

Abstract

A 13-year-old male presented with a 10-day history of left eye swelling and pain. These symptoms prompted presentation to the emergency department. He had no significant past medical history and no preceding fevers or chills. He was found on examination of the eyes and the orbit to have left supraorbital erythema, edema, and pain with upward and medial gaze. Examination of the globe, fundus, and visual fields were normal. His white blood cell count was 6.2 (x1000/mm3) with an erythrocyte sedimentation rate of 4 (mm/hr). Diagnostic endoscopic biopsy was performed. Here we present this case alongside clinical reasoning and diagnostic evaluation with relevant input from respective experts. This case discussion reviews the final diagnosis, as well as the corresponding evaluation and management. Diagnostic algorithms based on literature review and clinical experience are also included.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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