A Diagnostic Challenge: Periorbital or Orbital Cellulitis?

The authors present the case of a 39-year-old male who presented to the hospital with worsening eye pain, swelling, and blurred vision of the left eye. His symptoms grew worse despite initial over-the-counter medication and a trip to the urgent care center. A physical exam was concerning for a possible orbital cellulitis given the appearance of the eye and the amount of discomfort, as well as their immunocompromised status, necessitating imaging and workup to confirm the diagnosis. The patient was ultimately diagnosed with periorbital cellulitis and bacterial conjunctivitis, and he received intravenous antibiotics for treatment. This case underscores the importance of a comprehensive diagnostic approach to managing ocular infections.

Subungual Hematoma.

The authors present the case of a 64-year-old male who presented to the emergency department due to foot trauma. He sustained a large subungual hematoma, which was drained. Following the procedure, the patient achieved complete resolution of his pain. He also reported no complications at two-week phone follow-up. The management of subungual hematoma, including the trephination procedure, is discussed. Potential complications, although rare, are reviewed.

Hereditary Angioedema.

The authors present the case of a 22-year-old female who reported having a persistent sore throat. The patient had a history of recurring episodes of hereditary angioedema and arrived at the emergency department with her C1-esterase inhibitor. The epidemiology, clinical presentation, and treatment strategies are presented.

Stercoral Colitis Secondary to Opiate-Induced Constipation.

The authors present the case of a 62-year-old woman who had stercoral colitis secondary to opiate use for rheumatoid arthritis leading to chronic constipation. Computed tomography imaging demonstrated stool along a significant length of the colon. Stercoral colitis is a seldom suspected cause of severe abdominal pain. Although constipation may seem benign, when it gets to the level of a stercoral colitis, mortality due to colonic perforation is a very real concern. The authors review the presentation, risk factors, and management of stercoral colitis.