Presentation
Presented with history of fever and left eye swelling.
Patient Data
There is a peripherally contrast enhancing tract, which is most pronounced in the left retro-bulbar region. The tract can be visualized extending caudally between masticatory muscle bellies to the level of the left tympanic bulla. The left mandibular and medial retropharyngeal lymph nodes are moderately enlarged. The right mandibular lymph nodes are mildly enlarged.
Impression
Localized cellulitis with draining tract, likely due to a migrating foreign body such as a grass awn. Associated lymphadenopathy.
Case Discussion
The wound was probed and flushed, but no foreign material was identified. The tract resolved with antibiotic therapy.
Migrating foreign bodies are common in some geographic locations during the summer months. They may enter through the oral cavity or directly penetrating the skin. The fluid filled tract is characteristic, with contrast enhancing walls. The foreign body itself, if plant material, is rarely seen in a soft tissue tract.
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