A 22-year-old man presents with acute, painful swelling of the lateral part of the left upper eyelid. The lid shows a characteristic S-shaped curve, the preauricular node is palpable and tender, and he had parotid swelling two weeks ago. The most likely diagnosis is:
- A Internal hordeolum
- B Acute dacryoadenitis ✓
- C Chronic dacryocystitis
- D Orbital pseudotumor
Correct answer: B. Acute dacryoadenitis
Explanation
The lacrimal gland lies in the superotemporal orbit, and its swelling pushes the lateral upper lid down and out, producing the classic S-shaped deformity. Acute dacryoadenitis is painful, often viral, commonly mumps or Epstein-Barr virus, and typically accompanied by a tender preauricular lymph node, which also drains the lateral structures. An internal hordeolum is a focal tarsal abscess without S-shaped deformity, dacryocystitis swells inferonasally, and pseudotumor is usually more insidious with proptosis.
Reference: Khurana, Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.