ABSTRACT
This chapter presents a case study of a 6-year-old child who is admitted with a 3-day history of worsening right eyelid swelling. The child denies neurological symptoms like headache, weakness or numbness. He does not have any medical comorbidities and is up to date with immunisations. This patient has periobital preseptal cellulitis, secondary to acute rhinosinusitis. This is a potential sight-threatening emergency, which can have neurological complications such as meningitis, intracranial abscesses or cavernous sinus thrombosis via direct or haematogenous spread. From the outset, it requires multidisciplinary assessment and management by ENT surgeons, ophthalmologists, paediatricians, microbiologists and radiologists. Neurosurgeons have a role if there is intracranial involvement. Systemic features like fever and malaise are common. The patient's comorbidities and immunisation history are important. Precipitating factors may include upper respiratory tract infections, acute sinusitis or localised trauma (e.g. insect bites, injury).
