AN 18-MONTH-OLD child presented to the emergency department with a 5-day history of right orbital cellulitis (Figure 1) and tugging on the pinna of the right ear. By physical examination the child's temperature was 38°C, the right eyelid and conjunctivae were swollen and protuberant, and there was otitis media.
The child's pupils were not dilated, and the fundi were not well seen owing to the patient's eye movements. The patient had been seen at another hospital 3 days before and was treated with oral antibiotics for orbital cellulitis; however, the swelling of the right eye continued and the child was admitted for intravenous antibiotic treatment. Consultation with an ophthalmologist was obtained followed by a computed tomographic scan of the orbits (Figure 2).
Denouement and Discussion
Retinoblastoma Presenting With Orbital Cellulitis
Retinoblastoma is the most common intraocular malignancy of childhood. Although the initial symptoms are variable, a majority of patients (60%)
Kovanlikaya A, Nelson MD, Murphree AL. Radiological Case of the Month. Arch Pediatr Adolesc Med. 1996;150(8):873–874. doi:10.1001/archpedi.1996.02170330099017