A 36-year-old Caucasian female was referred for pre-septal cellulitis unresponsive to oral antibiotics. The patient reported a “bump” in the middle of her eyelid that became tender and swollen over 3 days. Her optometrist started her on Augmentin 875mg bid but the condition continued to worsen even after 3 days of taking the medication and using hot compresses. She presented to me as a referral with a large, very tender area of cellulitis, concerning for an abscess, without lid margin involvement. Vision, EOMs, pupils, and examination of the globe were within normal limits. Given the presentation, a methicillin-resistant staph aureus (MRSA) periorbital, pre-septal cellulitis was suspected. The patient was questioned about a history of MRSA and reported that, although she had never had a MRSA infection herself, her husband had been diagnosed with a MRSA infection the previous year.
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Great case. One I never want to see in my office. That would have certainly caused a tight sphincter if it progressed to that. Congratulations.
I’ve seen several preseptals over the last month or so. All cleared up with augmentin thankfully. I’ve seen one MRSA years ago. Thank you for sharing as this is a great reminder to be on the lookout for that. Great case shared here.
Good to see that she immediately put in her contact lens and eyeliner in the inside of the lid margin! ?!!
Exactly what I was thinking!