Differential Diagnosis for Edema of the Left Upper Eyelid
- Single most likely diagnosis
- Blepharitis or Hordeolum (Stye) caused by Staphylococcus aureus: The patient's symptoms of localized swelling, redness, a burning sensation, and a mildly erythematous pustule on the lid margin are classic for a hordeolum or stye, which is often caused by Staphylococcus aureus. The history of similar symptoms in the past also supports this diagnosis, as blepharitis and hordeolum can be recurrent.
- Other Likely diagnoses
- Chalazion: This is a common condition that presents with localized swelling of the eyelid due to a blocked meibomian gland. While it doesn't typically cause a pustule, it could be considered if the pustule is not a dominant feature.
- Allergic Conjunctivitis: This condition can cause eyelid edema, redness, and a burning sensation, especially if the patient has allergies. However, the presence of a pustule is less typical.
- Insect Bite or Contact Dermatitis: These could cause localized reactions but might not fully explain the pustule unless it's a secondary infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Orbital Cellulitis: Although less likely given the localized nature of the symptoms and the presence of a pustule, orbital cellulitis is a serious condition that requires prompt treatment. It can present with eyelid edema, redness, and pain, and can lead to serious complications if not treated.
- Herpes Zoster (Shingles): This can cause a painful rash and might lead to complications like herpes zoster ophthalmicus if it involves the eye. The presence of a burning sensation and localized swelling could be early signs.
- Rare diagnoses
- Granulomatosis with Polyangiitis (Wegener's Granulomatosis): This is a rare autoimmune disorder that can cause a wide range of symptoms, including eye inflammation and swelling. It would be an unusual cause of the patient's symptoms but should be considered if other diagnoses are ruled out and the condition worsens or does not respond to treatment.
- Sarcoidosis: This condition can cause uveitis and eyelid swelling among its many manifestations. It's rare and would typically be associated with other systemic symptoms.