DR. ATHEEK RASEENA

DR.SUBHA LAKSHMANAN, DR. ATHEEK SHAIK HAMEED, DR. K. S. SHAIK HAMEED

Abstract

5year-old child presented with h/o right upper eyelid swelling,fever and headache for 1week duration, treated elsewhere as hordeolum externum with preseptal cellulitis.On examination there was localized lid swelling on the lateral aspect of right upper eyelid associated with minimal pain and discharge.Anterior segment examination and fundus examination were normal.Investigations were done to exclude causes of fever including malaria dengue enteric fever and Covid19,they were found to be negative.After 2days lid swelling developed an eschar which gave a clue for diagnosis.IgM ELISA for scrub typhus was done,it was positive.Child was treated with systemic Azithromycin with which fever subsided and eschar was healed.Scrub typhus can also present with rare occurrence of eschar on lid margin which may be misdiagnosed as other eyelid swellings.Ophthalmologists should be aware of this condition in endemic areas when associated with fever and not responding to topical treatment.