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Panda sign due to severe coughing.
1Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. johnreid1@nhs.net
The Journal of the Royal College of Physicians of Edinburgh
|March 22, 2013
Summary
Severe coughing during an asthma attack can cause a rare condition called panda sign (periorbital ecchymosis). This eye bruising occurred without any head injury, highlighting an unusual cause for this sign.
Area of Science:
- Medicine
- Pulmonology
- Ophthalmology
Background:
- Periorbital ecchymosis, commonly known as the panda sign, is typically associated with basilar skull fractures.
- Asthma exacerbations can involve severe coughing, leading to significant intrathoracic pressure changes.
Observation:
- A patient presented with bilateral periorbital ecchymosis (panda sign) after experiencing severe coughing during an asthma exacerbation.
- The patient had no history of cranial trauma or other apparent causes for the sign.
Findings:
- Extensive investigations, including structural and hematological assessments, ruled out other potential causes for the periorbital ecchymosis.
- This case highlights severe coughing as a rare, but possible, etiology for the panda sign.
Implications:
- Recognizing severe coughing as a potential cause of the panda sign is crucial for accurate diagnosis in emergency settings.
- This finding broadens the differential diagnosis for periorbital ecchymosis, particularly in patients with respiratory conditions.
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