A six-year-old boy presented with fever up to 39.7 oC in October, headache and right eye pain for 24 hours.
On physical examination, mild erythema multiforme, non-complex erythema and proptosis were observed, with normal visual acuity.
Amoxicillin/clavulanate was prescribed at a dose of 80 mg/kg/day orally and the possible complications were reported.
Twenty-four hours after starting treatment, the patient came to the hospital emergency department for not tolerating oral antibiotics and persistent eye pain and fever.
In the hospital, ocular examination detected ptosis cerebellum right eye with pain to ocular mobility, mild erythema multiforme normal, iscoric and normoreactive pupils, ocular motility normal and fundus.
Among the complementary tests, the following stand out: blood count with leukocytes, 14 720/μl (N: 76.7%; L: 15.5%; M: 7.7%); C-reactive protein (CRP), 227.1 mg/l; CT-negative orbital inflammatory
She was admitted and treated with intravenous amoxicillin/clavulanic acid, which was maintained for six days, and was discharged with the same oral antibiotic for 15 days.
The evolution was favorable and without complications.
