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December 1992

Radiological Case of the Month

Author Affiliations

From the Department of Pediatrics, University of California, San Francisco.

Am J Dis Child. 1992;146(12):1471-1472. doi:10.1001/archpedi.1992.02160240081025

A 7½-year-old boy was evaluated because of high fever, general malaise, and erythema and swelling of the left eyelid. The presumptive diagnosis was periorbital cellulitis, and he started therapy with oral cefaclor. He was afebrile the next day, and ocular movements were described as normal, but redness of the periorbital area-was unchanged. On the third day (after 2 days of therapy with antibiotics), he was feeling well, and the periorbital redness and swelling were decreasing. Cefaclor therapy was continued, and 6 days later he resumed normal activity. However, on reevaluation there was proptosis of the left eye and downward displacement of the eye. Lateral and medial movements of the left eye were limited. He complained of fuzzy vision, diplopia, and tenderness to pressure on the eyeball. Funduscopic examination showed edema and blurring of the left disc margin. An axial computed tomographic scan of the orbits was obtained (Figure), and he

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