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Rapid progression of orbital abscess requiring lateral canthotomy in a pediatric patient
Matthew D Turner1, Steven Sandelich1, Catherine Marco1
1Emergency Medicine Department, Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
Insights
Subperiosteal abscess, a rare sinusitis complication in children, can rapidly threaten vision. Prompt identification and treatment by emergency physicians are crucial for preserving sight.
Area of Science:
- Ophthalmology
- Pediatric Otolaryngology
- Emergency Medicine
Background:
- Subperiosteal abscess (SPA) is an uncommon but serious complication of acute sinusitis, particularly in pediatric patients.
- Rapid progression of SPA can lead to significant morbidity, including vision loss.
Observation:
- An 11-year-old boy presented with a large SPA two days after a conjunctivitis diagnosis.
- The patient's SPA developed rapidly, indicating an aggressive disease course.
Findings:
- The pediatric patient required emergent interventions, including lateral canthotomy and cantholysis (LCC).
- Treatment also involved intravenous antibiotics and immediate surgical management to address the SPA.
Implications:
- Emergency physicians must maintain a high index of suspicion for SPA in children with sinusitis symptoms.
- Timely diagnosis and intervention, including surgical drainage and antibiotics, are critical to prevent vision-threatening complications.
Abstract:
Subperiosteal abscess (SPA) is a rare complication of acute sinusitis in children that may develop rapidly. In this case report, we describe an 11 year-old boy who presented with a large SPA 2 days after being diagnosed with conjunctivitis. The patient required emergent lateral canthotomy and cantholysis (LCC), IV antibiotics, and emergent surgery. It is crucial that emergency physicians be able to identify and treat this vision-threatening complication.
