Differential Diagnosis for Lower Lid Margin Stye Burst with Slight Swelling Underneath Eye
- Single most likely diagnosis:
- Hordeolum (Stye) with secondary preseptal cellulitis: This is the most likely diagnosis given the history of a stye bursting, which can lead to a localized infection causing swelling underneath the eye. The lack of significant erythema does not rule out this diagnosis, as the infection may still be in its early stages or partially contained.
- Other Likely diagnoses:
- Preseptal cellulitis: This condition, an infection of the eyelid and surrounding skin, could be a direct consequence of the stye bursting, spreading the infection to the surrounding tissues.
- Meibomian cyst or abscess: If the stye was actually a meibomian gland abscess that ruptured, it could lead to swelling underneath the eye due to the location of the meibomian glands within the tarsal plate of the eyelid.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Orbital cellulitis: Although less likely than preseptal cellulitis due to the lack of significant erythema and the fact that the swelling is described as slight, orbital cellulitis is a serious condition that requires immediate attention. It involves infection posterior to the orbital septum and can lead to severe complications, including vision loss and cavernous sinus thrombosis.
- Cavernous sinus thrombosis: This is a rare but potentially life-threatening complication of facial infections, including those of the eyelid. Early recognition and treatment are crucial.
- Rare diagnoses:
- Dacryocystitis: Inflammation of the lacrimal sac, which could potentially cause swelling in the area underneath the eye, although it's less directly related to a stye bursting.
- Angioedema: A condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues, which could theoretically cause swelling underneath the eye. However, it typically presents with more pronounced symptoms and is not directly related to a stye.