A 6-year-old boy presents with acute onset of right periorbital swelling, erythema, and warmth for 2 days. He has a low-grade fever. On examination, visual acuity is normal, there is no proptosis, and extraocular movements are full and painless. What is the most likely diagnosis?

• A Allergic angioedema
• B Orbital cellulitis
• C Acute dacryocystitis
• D Preseptal cellulitis ✓

Explanation

Preseptal cellulitis involves tissues anterior to the orbital septum. It presents with lid swelling and erythema but lacks posterior extension. The absence of proptosis, ophthalmoplegia, or visual loss distinguishes it from orbital cellulitis, which involves structures posterior to the septum. Acute dacryocystitis is localized to the medial canthal area, and angioedema lacks fever and is typically non-tender.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.