A case of Eosinophilic Cellulitis causing orbital edema and ecchymosis in a child

TL;DR

A 10-year-old boy presented with a rare case of Eosinophilic Cellulitis affecting his eye, successfully treated with corticosteroids after a biopsy confirmed the diagnosis.

Contribution

This paper reports a rare pediatric case of orbital Eosinophilic Cellulitis, highlighting its unusual presentation and effective treatment.

Findings

The patient's symptoms were initially misdiagnosed as orbital cellulitis but were confirmed as Eosinophilic Cellulitis via biopsy.

Treatment with oral corticosteroids led to full resolution of the patient's condition.

This case adds to the limited literature on orbital involvement of Eosinophilic Cellulitis in children.

Abstract

To describe an unusual case of Eosinophilic Cellulitis (Wells’ Syndrome) with orbital involvement presenting in a 10-year-old boy, which was successfully treated with systemic corticosteroids after incisional biopsy and pathologic diagnosis.

A 10-year-old boy was referred to our emergency department with a sudden onset of painless ecchymosis and edema of his left periorbital region. Computed tomography was concerning for orbital cellulitis, however, the history and clinical presentation were inconsistent with this radiographic diagnosis. The patient underwent an incisional biopsy with pathology revealing eosinophilic cellulitis. The patient's condition resolved after treatment with oral corticosteroids.

Eosinophilic cellulitis is a rare dermatosis characterized by large, inflamed, edematous patches. It usually affects adults and is mainly located on the extremities. This is a unique case due to the patient demographics and the location of this disease, with only a few orbital eosinophilic cellulitis cases reported in the literature.

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