International Medical Case Reports Journal (Aug 2019)
Orbital cellulitis clinically mimicking rhabdomyosarcoma
Abstract
Suliati P Amir,1,2 Muhammad Irfan Kamaruddin,1 Marliyanti Nur Rahmah Akib,1,2 Junaedi Sirajuddin11Department of Ophthalmology, Hasanuddin University, Makassar, South Sulawesi, Indonesia; 2Department of Ophthalmology, Muslim University of Indonesia, Makassar, South Sulawesi, IndonesiaCorrespondence: Muhammad Irfan KamaruddinDepartment of Ophthalmology, Hasanuddin University, Jalan Antang Raya, Kompleks Beverly Hills Blok B 21, RT 009/RW 001, Kelurahan Antang, Kecamatan Manggala, Makassar 90234, South Sulawesi, IndonesiaTel +62 8 524 015 9116Email [email protected]: Proptosis in children with acute-onset accompanied by signs of inflammation is commonly caused by orbital cellulitis, however, the possibility of rhabdomyosarcoma should always be considered by the clinician. This is a case report of a five-year-old boy presenting with an acute-onset of proptosis without a history of trauma and systemic infection. Our clinical differential diagnosis included orbital cellulitis and orbital rhabdomyosarcoma.Purpose: To report a case of orbital cellulitis that clinically and radiologically mimics rhabdomyosarcoma.Case presentation: A five-year-old boy presented with rapid-onset proptosis, periorbital edema, pain and visual loss in the left eye for two weeks without a history of trauma, upper respiratory tract infection, sinusitis or immunosuppression. Our clinical differential diagnosis includes rhabdomyosarcoma and orbital cellulitis. Complete blood count reveals a leukocytosis. Multislice computed tomography (MSCT) scan shows lesions involving the lateral orbit and the retro bulbar space. Antibiotics combination and adjunct anti-inflammatory intravenously shows excellent clinical resolution.Conclusions: The study demonstrates difficulty in differentiating acute orbital cellulitis from rhabdomyosarcoma based on clinical findings. In addition, the case highlights that antibiotic combination of cephalosporin and aminoglycosides together with an adjuvant corticosteroid as an anti-inflammatory was effective in the case of acute orbital cellulitis.Keywords: proptosis, corticosteroid, cellulitis, rhabdomyosarcoma
