https://orcid.org/0000-0001-6052-9107
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Petros Koltsidopoulos, Eleni Papageorgiou, Charalampos Skoulakis, Eyelid lump in child associated with dog scratch, Postgraduate Medical Journal, Volume 95, Issue 1130, December 2019, Page 675, https://doi.org/10.1136/postgradmedj-2019-136431
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A 14-year-old girl presented with a left upper eyelid diffuse swelling and an ipsilateral pseudoptosis (figure 1A). She had been referred by a general practitioner as an urgent case of orbital cellulitis. She had already received 2 days of treatment with oral clindamycin without improvement in symptoms. The patient’s general medical history was unremarkable. Her family owned two dogs and she had been bitten by them several times during playing. Nasal endoscopy was performed. No purulent secretions were found in the middle meatus. MRI showed a soft tissue mass in the upper lid without any paranasal sinus pathology (figure 1B). The patient continued the antibiotic treatment and the swelling subsided gradually. However, 20 days later, she presented again with a solid nodule beneath the left eyelid skin and a concomitant swelling in the preauricular region. An excisional biopsy of the upper eyelid mass through blepharoplasty approach was performed (figure 1C). The histopathological findings were suggestive of cat scratch disease (CSD) (figure 1D). Serological testing (detection of IgM and IgG Bartonella henselae antibodies by enzyme immunoassay) and PCR assay for B. henselae were both positive and confirmed the diagnosis. The patient recovered after treatment with azithromycin.
