A 6-year-old boy was referred to our hospital with orbital cellulitis. He had a history of 7 days of fever despite antibiotherapy. At first, he only had pharyngitis and conjunctivitis, but then an orbital mass evolved which restricted the movement of his right eye and there was also periorbital inflammation resembling orbital cellulitis. Examination at presentation revealed conjunctivitis with secretion, periocular inflammation and edema, right-preauricular lymphadenopathy and restriction of upgaze in the right eye. Laboratory findings included a white blood cell count of 19,000 cells per mm3, with 81.5% neutrophils, 15.0% lymphocytes, 1.2% monocytes and 0.4% basophils. The erythrocyte sedimentation rate was 52 mm/h and the C-reactive protein level was 46.3 mg/dl. Magnetic resonance imaging confirmed orbital cellulitis and pansinusitis. Vancomycin (60 mg/kg/day) and meropenem (100 mg/kg/day) were administered, but desquamation on his fingertips and a rash appeared on the tenth day. A pediatric consultation resulted in a diagnosis of incomplete Kawasaki disease (KD). After administration of aspirin, the orbital inflammation regressed in 3 days. No coronary artery lesions were detected on the first echocardiography, but these did appear 6 weeks later. This confirmed the KD diagnosis.
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机译：一名6岁男孩因眼眶蜂窝织炎被转诊至我们医院。尽管进行了生物疗法，他仍有发烧7天的病史。起初，他仅患有咽炎和结膜炎，但随后发展为眼眶肿块，从而限制了其右眼的活动，还出现了眼眶炎，类似于眼眶蜂窝织炎。出席检查时发现结膜炎伴有分泌物，眼周炎症和水肿，右耳前淋巴结病和右眼凝视受限。实验室检查结果包括每平方毫米19,000个细胞的白细胞计数，其中中性粒细胞占81.5％，淋巴细胞占15.0％，单核细胞占1.2％，嗜碱性粒细胞占0.4％。红细胞沉降速率为52 mm / h，C反应蛋白水平为46.3 mg / dl。磁共振成像证实了眼眶蜂窝织炎和pansusususitis。给予万古霉素（60 mg / kg /天）和美罗培南（100 mg / kg /天），但在第十天出现指尖脱屑和皮疹。儿科会诊诊断为不完整的川崎病（KD）。服用阿司匹林后，眼眶炎症在3天内消退。第一次超声心动图检查未发现冠状动脉病变，但确实在6周后出现。这证实了KD诊断。
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