Case Questions
Chief Complaint: I have red eye
Demographic
Age: 10
Biological sex: Male
Race: Asian
Ethnicity: Not Hispanic or Latino
Medications
None
Before you continue, what questions do you want to ask this patient?
Torretta S, Guastella C, Marchisio P, et al. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. J Clin Med. 2019;8(1):101. Published 2019 Jan 16. doi:10.3390/jcm8010101 (cropped)
ROS
Constitutional: Denies
Genitourinary: Denies
ENT: Denies
Musculoskeletal: Denies
Cardiovascular: Denies
Neurologic: Headaches
Pulmonary: Denies
Psychiatric: Denies
Endocrine: Denies
Immunologic: Denies
Dermatological: Denies
Hematologic: Denies
Gastrointestinal: Denies
Obstetrical: Denies
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Orbital CT with contrast to rule out orbital disease
Format: [Testing] [Reason]
Example: Fundus photos to rule out retinal disease
Torretta S, Guastella C, Marchisio P, et al. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. J Clin Med. 2019;8(1):101. Published 2019 Jan 16. doi:10.3390/jcm8010101
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Orbital cellulitis, OD
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Educated patient on today’s findings. Referred to PCP or ER STAT for initiation of intravenous antibiotic therapy for orbital cellulitis. Return to clinic in 1 day after discharge from the ER to monitor visual acuity, red desaturation, extraocular motility, proptosis, intraocular pressure, corneal integrity, and optic nerve function. Consider systemic oral antibiotic (e.g., Augmentin 250–500 mg PO TID, Cefaclor 250–500 mg PO TID, or Bactrim DS PO BID for penicillin allergy) following improvement with IV therapy.
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Patient was informed of diagnosis of orbital cellulitis, a serious infection behind the eye that can result from sinus infections, trauma, or spread from nearby tissues. Explained that this condition can affect vision and eye movement and requires urgent treatment with intravenous antibiotics. Reviewed referral to PCP for immediate IV therapy and discussed importance of completing full treatment, including a transition to oral antibiotics once improved. Advised patient to monitor for worsening pain, vision loss, fever, or increased eye swelling, and to seek emergency care if symptoms progress.