Presentation
Recent fall 3 days ago. Acute onset of fever, periorbital swelling, and facial tenderness.
Patient Data
There is a fracture dislocation of the right maxillary central incisor, right lateral incisor, right canine teeth, and a partial dislocation of the left maxillary central incisor. Adjacent to this area, there is significant soft tissue stranding but also tracks along the right lateral face to the level of the orbit. Lateral to the right canine tooth, there is a rim-enhancing collection. There are foci of air both anterior and deep to this collection.
There is a right periorbital and infraorbital soft tissue swelling. There is minimal post-septal fat stranding along the inferolateral aspect of the globe. There is no intraorbital rim-enhancing collection. The globes, optic nerve sheaths, extraocular muscles, and lacrimal glands demonstrate a symmetric and unremarkable appearance.
Case Discussion
This is a case of dental trauma in a pediatric patient. There is associated soft tissue swelling along the fractures, as well as a rim-enhancing collection (presumed to be a small abscess). The swelling tracks along the face to involve the intraorbital fat with concern for pre- and post-septal cellulitis, respectively. The patient was prescribed antibiotics and referred to dentistry for the dental fractures.
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