Rosh Pediatrics Practice Exam

A 3-year-old with eyelid swelling and redness after a viral infection is most likely diagnosed with?

1. ABlepharitis

2. BHordeolum

3. COrbital cellulitis

4. DPreseptal cellulitis

The correct answer is: DPreseptal cellulitis

In the context of a 3-year-old experiencing eyelid swelling and redness following a viral infection, the most appropriate diagnosis is preseptal cellulitis. This condition commonly arises as a result of an adjacent infection, such as sinusitis or viral conjunctivitis, especially in young children. Preseptal cellulitis involves the soft tissues of the eyelid and surrounding areas, and it typically presents with localized swelling and redness without proptosis or ocular movement restriction, distinguishing it from other more severe conditions like orbital cellulitis, which would present with systemic illness and potentially serious complications. The differential diagnosis might include conditions like blepharitis or hordeolum, which usually relate to inflammation of the eyelid margins or meibomian glands and might not directly correlate with a recent viral illness. Orbital cellulitis, in contrast, is a more serious condition associated with deeper tissue involvement and often necessitates immediate medical attention. Therefore, considering the patient's viral infection history and the symptom presentation, preseptal cellulitis is the most likely diagnosis, aligning with the clinical scenario typically observed in pediatric cases.