Prepared by Shomeet V. Patel, MD, Resident, Harold P. Katner, MD, Chief, Infectious Diseases, and Professor, A. Rakesh Sarma, MD, Resident, and Edwin W. Grimsley, MD, Program Director, and Professor, Department of Internal Medicine, Mercer University School of Medicine, Macon, Ga

A 45-year-old man with a history of chronic alcohol abuse, pancreatitis, and chronic, untreated sinusitis presented to the emergency department with complaints of abdominal pain and intermittent right-sided throbbing headaches that were nonradiating. Physical examination revealed a 3- x 3-cm nonpulsatile, nontender, fluctuant swelling over the right brow. The patient was admitted for further evaluation. Twenty-four hours postadmission, right-eye ptosis was evident, accompanied by an increase in the size of the swelling to 4 x 5 cm (Figure 1).

What’s Your Diagnosis?

Inflamed epidermoid cyst

Cellulitis

Frontal bone osteomyelitis

Eosinophilic granuloma