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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