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Home » Infection

Consultant. Vol. 49 No. 4
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What’s Your Diagnosis?
Sharpen Your Physical Diagnostic Skills 

Something Wrong on the Face of an Old Man

By HENRY SCHNEIDERMAN, MD—Series Editor | April 1, 2009
Dr Schneiderman is vice-president for medical services and physician-in-chief, Hebrew Health Care, West Hartford, Conn, and president of its Connecticut Geriatric Specialty Group. He is professor of medicine (geriatrics) and associate professor of pathology, University of Connecticut Health Center in Farmington and clinical professor, nursing, Yale University. He is a recipient of the American Geriatrics Society Clinician of the Year award and received the Laureate award of the Connecticut chapter of the American College of Physicians.

This article was originally presented as an independent educational activity under the direction of CME LLC. The ability to receive CME credits has expired. The article is now presented here for your reference. CME LLC is no longer responsible for the presentation of the article.

HISTORY

ImageA 76-year-old man is seen because of redness below the right eye. Has long-standing “lazy eye” on the left, which is chronically deviated outward. Has lived in nursing home for some years due to self-care deficit from memory loss. No recent eye surgery, conjunctivitis, sinus infection, or periocular trauma.

PHYSICAL EXAMINATION

Man who does not effectively communicate how much of his moderate discomfiture is psychological versus physical. Temperature, 37.3°C (99.2°F); heart rate, 84 bpm and regular; BP, 126/84 mm Hg; respirations, 20 per minute and not labored. Face as shown. Visual function seems preserved within limits of his replies. Full ocular range of motion. Each pupil constricts on direct illumination and consensually on shining flashlight beam into opposite eye.

What’s Your Diagnosis?

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by Yvonne Eichler | January 27, 2010 3:55 PM EST

periorbital infection

by manijeh ghasemi | March 10, 2010 11:02 AM EST

Sub orbital /maxillary abcess

 

by Jin Guo | March 11, 2010 7:23 PM EST

periorbital cellulitis

by shehla jaffery | April 01, 2010 1:55 PM EDT

erysepilas

by laila azzuz | April 08, 2010 5:26 PM EDT

periorbitla cellulitis

 

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