Abstract：
A girl in early childhood with no significant medical history developed left eye periorbital oedema and erythema. She was treated with intravenous antibiotics for suspected severe periorbital cellulitis. Despite treatment, the patient\'s cellulitis progressed into necrotising fasciitis, and she was transferred for ophthalmology review and imaging. A CT scan and eye swab culture-confirmed Staphylococcus aureus periorbital cellulitis. Incidentally, pathology revealed significant pancytopenia suspicious of leukaemia. The patient underwent bone marrow biopsy and was diagnosed with B-cell acute lymphoblastic leukaemia (ALL). A multidisciplinary specialist assessment revealed no ocular evidence of leukaemia and no intraocular concerns. In medical literature, it is consistently found that cases of ALL initially manifesting as proptosis or eyelid oedema are invariably due to neoplastic infiltration. This case represents unique documentation where periorbital cellulitis is the initial presentation of B-cell ALL, underscoring the necessity to consider periorbital cellulitis as a possible differential diagnosis in ophthalmic manifestations of ALL.
摘要：
一名儿童早期无明显病史的女孩出现左眼眶周水肿和红斑。她因怀疑严重的眶周蜂窝织炎而接受静脉注射抗生素治疗。尽管治疗,患者的蜂窝织炎进展为坏死性筋膜炎，她被转移进行眼科检查和成像。CT扫描和眼拭子培养证实金黄色葡萄球菌眶周蜂窝织炎。顺便说一句,病理显示可疑白血病的全血细胞减少症。患者接受了骨髓活检，并被诊断为B细胞急性淋巴细胞白血病（ALL）。多学科专家评估显示，没有白血病的眼部证据，也没有眼内问题。在医学文献中,一直发现，最初表现为眼球突出或眼睑水肿的ALL病例总是由于肿瘤浸润。该病例代表了独特的文献，其中眶周蜂窝织炎是B细胞ALL的最初表现，强调必须考虑眶周蜂窝织炎作为ALL眼科表现的可能鉴别诊断。
