RESUMEN
We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.
Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Desbridamiento/métodos , Sinusitis Frontal/terapia , Celulitis Orbitaria/terapia , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Adolescente , Antibacterianos/uso terapéutico , Betacoronavirus , COVID-19 , Prueba de COVID-19 , Niño , Técnicas de Laboratorio Clínico/métodos , Terapia Combinada/métodos , Servicio de Urgencia en Hospital , Estudios de Seguimiento , Sinusitis Frontal/diagnóstico por imagen , Sinusitis Frontal/etiología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Celulitis Orbitaria/diagnóstico por imagen , Celulitis Orbitaria/etiología , Pandemias , Medición de Riesgo , SARS-CoV-2 , Muestreo , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
INTRODUCTION: Acute painful scrotum in children may be associated with torsion of the testis, hematocele, epididymitis and direct testicular injury with hematoma formation. More frequently, however, acute scrotum occurs without a precipitating factor. While most traumatic testicular injuries resolve with conservative management, many require surgical exploration and some are life-threatening. CASE PRESENTATION: A 13-year-old boy with a history of testicular trauma presented with severe scrotal swelling and shock. This case study examines the presentation and possible role of cytokines in the development of systemic inflammatory response syndrome in a child with acute traumatic epididymitis. CONCLUSION: Post-traumatic epididymitis presenting as shock in boys is rarely reported. We advocate early recognition of the chain of events leading to clinical presentation of shock and prompt treatment to preserve testicular viability.