Differential Diagnosis for a 2-year-old Boy with Lid Swelling
- Single most likely diagnosis:
- Periorbital cellulitis: This is a common condition in children, often caused by bacterial infections such as Haemophilus influenzae or Streptococcus pneumoniae. The symptoms include eyelid swelling, redness, and warmth, which are consistent with the presentation.
- Other Likely diagnoses:
- Allergic conjunctivitis: This condition can cause eyelid swelling, especially if the child has a history of allergies. It is often accompanied by itching, redness, and discharge.
- Blepharitis: This is an inflammation of the eyelids that can cause swelling, redness, and crusting. It is often associated with poor eyelid hygiene or meibomian gland dysfunction.
- Hordeolum (stye): A localized infection of the eyelid margin, which can cause swelling, redness, and pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Orbital cellulitis: Although less common than periorbital cellulitis, orbital cellulitis is a serious condition that requires prompt treatment. It can cause proptosis, vision loss, and even cavernous sinus thrombosis if left untreated.
- Rhabdomyosarcoma: A rare but aggressive tumor that can cause eyelid swelling and proptosis. Although unlikely, it is essential to consider this diagnosis to avoid delayed treatment.
- Rare diagnoses:
- Angioedema: A rare condition that can cause sudden, severe eyelid swelling, often accompanied by other symptoms such as facial swelling and difficulty breathing.
- Granulomatosis with polyangiitis (Wegener's granulomatosis): A rare autoimmune disorder that can cause eyelid swelling, sinusitis, and respiratory symptoms.
- Sarcoidosis: A rare condition that can cause eyelid swelling, uveitis, and other systemic symptoms.