Orbital emphysema during air travel: a case report.

Orbital emphysema is a well-recognized complication of fractures involving the orbit. Commonly, this follows nose blowing and occurs in the subcutaneous tissues. A case of emphysema within the orbital cavity caused by the pressure changes during air travel is presented. The clinical picture was similar to that seen in retrobulbar haemorrhage and required early surgical intervention. Circumstances where patients at risk may be exposed to abnormal atmospheric pressures are highlighted and the management of the condition is discussed.

Impetigo presenting as an acute necrotizing swelling of the lower lip in an adult patient.

The authors present an unusual case of an acute swelling of the lower lip and septicemia in a 35-year-old, recent immigrant male arriving from India. The patient presented in our emergency department with a 48-hour history of a worsening, painful swelling of the lower lip. On presentation, he was pyrexial and the lip was found to be acutely inflamed with honey-colored crusting, pustular lesions, and induration . A diagnosis of impetigo leading to necrosis of the lip was established, a rare phenomenon potentially resulting in significant tissue destruction. Appropriate medical management achieved a good outcome and prevented disabling tissue loss of the orofacial region.