Eyelid lump in child associated with dog scratch

A 14-year-old girl presented with a left upper eyelid diffuse swelling and an ipsilateral pseudoptosis (figure 1A). She had been referred by a general practitioner as an urgent case of orbital cellulitis. She had already received 2 days of treatment with oral clindamycin without improvement in symptoms. The patient’s general medical history was unremarkable. Her family owned two dogs and she had been bitten by them several times during playing. Nasal endoscopy was performed. No purulent secretions were found in the middle meatus. MRI showed a …