Orbital emphysema as a rare complication of asthma exacerbation in a pediatric patient; A case report

TL;DR

A rare case of orbital emphysema in a child with asthma after an influenza infection is reported, highlighting its possible link to asthma exacerbation.

Contribution

This is the first reported case of orbital emphysema following influenza-induced asthma exacerbation in a pediatric patient.

Findings

Orbital emphysema was diagnosed alongside pneumomediastinum and subcutaneous emphysema in a child with asthma.

The condition resolved completely with conservative management and no long-term effects.

The case suggests a possible pathogenesis involving fascial plane spread from subcutaneous emphysema.

Abstract

Spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SCE) are well-known complications of asthma. Orbital emphysema (OE) is a rare complication, with little known of its pathogenesis and clinical significance. This report presents a case of OE associated with asthma exacerbation in a pediatric patient.

An 8-year-old girl with a history of asthma treatment developed wheezing and periorbital swelling around her right eye following influenza A infection. She had no history of trauma, nose blowing, or recent surgery. Head and chest computed tomography revealed SPM, massive SCE, and right OE. Intraocular pressure and visual acuity were normal. OE, SCE, and SPM were completely resolved through conservative management, without any sequelae.

OE may be associated with asthma exacerbation in pediatric patients. We hypothesized that the massive SCE and SPM, which developed as a result of asthma exacerbation, spread through the fascial planes, leading to the development of OE.

OE is typically a benign self-limiting condition; however, it may lead to serious complications such as orbital compartment syndrome. Clinicians should consider OE in patients with asthma who present with sudden orbital symptoms, even in the absence of a history of trauma.

•Orbital emphysema was identified as a rare complication of asthma exacerbation.•This is the first case report of orbital emphysema following influenza infection.•This case provides valuable insights into the pathogenesis of orbital emphysema.

Orbital emphysema was identified as a rare complication of asthma exacerbation.

This is the first case report of orbital emphysema following influenza infection.

This case provides valuable insights into the pathogenesis of orbital emphysema.

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