A 14-year-old girl was referred for evaluation of a several-year history of growth failure, chronic abdominal pain, and intermittent emesis. The parents described the child as a "picky eater," and various foods (eg, meat products and beans) frequently caused abdominal distention.
A 4-year-old girl presents with a highly pruritic rash. The day before, she had been playing outdoors at her grandmother's house. No pets were present, and the patient does not recall being stung or bitten by insects. There are bushes on the grandmother's property.
The child has orbital cellulitis, an infection with sometimes serious sequelae that involves the soft tissue of the orbit posterior to the orbital septum. Children are more likely than adults to contract orbital cellulitis; the median age of those affected is 7 years. Preseptal cellulitis--the other major infection of the ocular and adnexal orbital tissue--involves the soft tissue of the eyelids and periocular region anterior to the orbital septum and is considered less severe.