Frontal Mucopyocoele Presenting With Recurrent Periorbital Cellulitis: A Delayed Diagnosis

Abstract

Periorbital cellulitis is an uncommon presentation to primary care and the emergency department. With multiple aetiologies, it is crucial that an appropriate history and examination are applied to identify the primary cause and initiate therapy in a timely manner.We present a 30-year-old male who presented with recurrent periorbital cellulitis treated repeatedly with antibiotics without consideration of the origin of the infection. Subsequent investigations discovered a widely dehiscent mucopyocoele of the frontal sinus that had been unrecognised and untreated. Once identified, the patient underwent functional endoscopic sinus surgery to clear the mucopyocoele and improve the drainage of the frontal sinus. Symptoms have not recurred since the surgical intervention.A poor understanding of the aetiologies of periorbital cellulitis and the related anatomy likely played a role in his delayed definitive management. Clinicians should be aware that in a patient presenting with periorbital swelling and erythema, consideration should be given to the possibility of underlying sinonasal pathology.