Case Report of Unusual Facial Swelling in an 8-Month-Old

Area of Science:

• Pediatric Medicine
• Toxicology
• Emergency Medicine

Background:

• Rhabdomyolysis is a severe condition involving muscle breakdown and release of intracellular contents into circulation.
• It is typically seen in adults with crush injuries, overexertion, or drug/alcohol overdose, and is rare in young children.
• Localized severe swelling in children can have various causes, including trauma and infection.

Purpose of the Study:

• To report an unusual case of rhabdomyolysis in an infant secondary to prolonged facial muscle compression.
• To emphasize the need to consider rhabdomyolysis in the differential diagnosis of severe localized swelling in pediatric patients.
• To discuss the clinical presentation, management, and outcome of this rare pediatric case.

Main Methods:

• Case report of an 8-month-old female infant.
• Clinical presentation of progressive right-sided facial swelling, drooling, and intraoral edema.
• Diagnostic work-up including laboratory tests and imaging.
• Treatment with intravenous fluids, steroids, and antibiotics.

Main Results:

• The infant's condition was diagnosed as rhabdomyolysis resulting from prolonged facial muscle compression.
• The patient showed improvement with medical management, including IV fluids, steroids for swelling, and antibiotics for cellulitis.
• At follow-up, swelling resolved with minimal scarring and a mild facial nerve palsy.

Conclusions:

• This case demonstrates that rhabdomyolysis can occur in infants due to prolonged external pressure on muscles.
• Pediatric healthcare providers should consider rhabdomyolysis in the differential diagnosis of severe localized swelling in children, even in the absence of typical risk factors.
• Prompt recognition and management are crucial for favorable outcomes in pediatric rhabdomyolysis.