Paingod wrote: ↑Fri Sep 14, 2018 1:56 pm
Freyland wrote: ↑Fri Sep 14, 2018 10:44 amKeep us informed!
The results of the CT scan are in. The doctor explained it to me as this...
No signs of orbital cellulitis or abscesses. Sinuses and glands on the CT scan looked clear. The superior rectus muscle of the eye is swollen or thickened. She wasn't sure why I'd have eyelid edema and it wouldn't be common with this issue, but she figures that there may be something that antibiotics killed and the muscle hasn't calmed down yet. She says this rules out this being an emergency situation - unless something unsual happens over the weekend, like my eye continues to swell or closes. She did ask if I've got thyroid issues, which I don't - or am not aware of. She said that as an extreme outlier, it may be orbital lymphoma.
I need to find a PCP next week and get my blood work done to rule out thyroid issues before any more guessing is done. I'll finish the course of antibiotics I'm on, but it doesn't look like there's a lingering infection right now.
So...
Thanks for the update. So my thoughts/explanations, if you will have them:
1) No abscess--> Yay!
2) Chronic thyroid issues can cause the build-up of myxedema of the eye muscles, which can in turn cause the eyes to bulge. That said, one muscle involvement, associated with infectious symptoms, seems like this is unlikely. Not saying dont get the labs, just reviewing your situation with info at hand.
3) Orbital lymphoma? As she stated, extreme outlier (especially with normal surrounding glands, but even without that detail, extreme outlier).
4) So, where my opinion on things differ is the severity of your infectious situation. The swollen muscle on the CT attaches to, and runs adjacent to, the eyeball. This is exactly the region of "Peri-orbital" (not pre-septal) cellulitis. She and I agree that your findings are better than they could be due to the previous oral antibiotic use. We differ because I see you as a partially-treated peri-orbital cellulitis and she (seems) to view you as a partially treated pre-septal cellulitis.
So, where does that leave you? Of course, follow the directions you were given and take the abx your were given. Would suggest careful follow up, and exactly as she said, if you have worsened symptoms of eye pain with movement, eye swelling, eye paralysis, vision worsening then ER is absolutely appropriate. I would argue that fever and/or headache would justify ER as well, based on the concerns I have given you. Keep us informed, and I hope to hear things are getting better!
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