Subperiosteal abscess in a toddler with white eye

Azima Ahmad Shahrudin, Intan-Shafinaz Mohd Radzuan, Adlina Abdul Rahim, Sakina Mohd Saad, Nurliza Idris, Zunaina Embong


Subperiosteal abscess is a life and vision threatening infection of the orbit and is a common complication of rhinosinusitis in children. A 16-month-old Malay boy presented with progressive swelling of upper and lower lids of the left eye for 2 days. He had fever with runny nose 4 days prior to eye symptoms.  He was treated as left eye pre-septal cellulitis with intravenous antibiotic.  However, on day 4 of admission, his left eye developed proptosis and urgent contrast enhanced computerized tomography of orbit and paranasal sinus revealed left eye orbital cellulitis complicated with left subperiosteal abscess together with left ethmoidal and maxillary sinusitis. Surgical drainage via functional endoscopic sinus surgery was performed.  Postoperatively, the left eye proptosis markedly reduced with resolution of eyelids swelling. Thorough examination with high index of suspicious and interdisciplinary approach in management leading to successful treatment.




Subperiosteal abscess; sinusitis; ethmoiditis; orbital cellulitis

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