A two year old child with a long history of purulent nasal discharge & fever now presents with conjunctival congestion and edema. His fever is 102deg/103degF and WBC count 12,000. The culture of eye discharge was negative. X-rays show opacification of ethmoid sinus. Which of the following should be the next step in evaluating this patient?
A patient presenting with long standing history of purulent nasal discharge, fever, opacification of sinus and development of conjunctival congestion with edema suggests a diagnosis of chronic sinusitis associated with orbital complications (orbital cellulitis or abscess). Therefore, a CT scan or ultrasound of the orbit should be next step in this patient's evaluation. Ref: Diseases of Ear, Nose and Throat By PL Dhingra, 4th Edition, Chapter 37 and 38; Handbook of Otolaryngology : Head and Neck Surgery By David Goldenberg, Bradley Goldstein
CT Scan
Urine Culture
Blood culture
Repeat culture of eye discharge