LAUSR

A properly immunised 7-year-old male with no prior history of note came to the emergency department due to swelling and right palpebral erythema. His signs and symptoms had started 72 h earlier with a pustular lesion on his upper eyelid. He came in as his inflammatory signs had worsened despite treatment with oral amoxicillin–clavulanic acid. He reported no history of a bite or sting and no history of cutaneous herpes. A physical examination revealed that he was afebrile with right palpebral swelling that made it difficult for him to open his eye and a crusty lesion on his upper eyelid (Fig. 1). Painful right submandibular lymphadenopathy measuring 2 cm × 2 cm was palpated. Apart from these findings, the examination was normal. Blood testing revealed leukocytes 15,700 mm–3 (neutrophils 10,000 mm–3) and C-reactive protein 3 mg/dl. Blood was drawn for culture. Purulent content was drained from the wound for culture as well. With a diagnosis of preseptal cellulitis, the patient was admitted with intravenous amoxicillin–clavulanic acid, and his wounds were dressed and drained. He showed a great deal of improvement following 3 days of hospitalisation and was sent home to continue on oral antibiotic therapy.