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Video

Pediatric Otolaryngology

(A924) Facial Swelling, Fever, and a Feather: A Case of Persistent Pediatric Infection

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Valerie Stichert, BS

    Medical Student
    University of Cincinnati College of Medicine
    Cincinnati, Ohio, United States

    • Co-Author(s)

  • Rahul Patel, Other

    Medical Student
    University of Cincinnati College of Medicine
    Hamilton, Ohio, United States

    • Co-Author(s)

  • Vilok Desai, MD

    Resident
    University of Cincinnati College of Medicine
    Cincinnati, Ohio, United States

    • Senior Author(s)

  • Dv

    Douglas C. von Allmen, MD

    Assistant Professor
    Cincinnati Childrens Hospital
    Cincinnati, Ohio, United States

Disclosure(s):
Rahul Patel, Other: No relevant relationships to disclose.
Valerie Stichert, BS: No relevant relationships to disclose.
Vilok Desai, MD: No relevant relationships to disclose.
Douglas C. von Allmen, MD: No relevant relationships to disclose.


Introduction: Foreign body-induced abscesses in pediatric patients are rare, particularly in atypical locations like the temporal scalp. Literature on feather foreign bodies causing abscesses is extremely limited, with no documented cases involving the temporal region. This report presents the first known case of a temporal abscess caused by a retained feather in a 13-month-old male, emphasizing the role of comprehensive imaging and multidisciplinary care in managing unusual pediatric infections.

Methods: This retrospective case study describes the clinical presentation, diagnostic evaluation, and comprehensive management of a temporal abscess caused by a retained foreign body. The role of imaging, surgical intervention, and postoperative care is discussed with a focus on the diagnostic and therapeutic challenges unique to pediatric patients with atypical infections.

Results: The patient initially presented with facial swelling, erythema, and tenderness, diagnosed as cellulitis. Symptoms persisted despite two courses of antibiotics, prompting advanced imaging, which identified a foreign body and abscess in the temporal region. Surgical incision and drainage revealed a 5 cm feather and purulent material, with cultures growing Staphylococcus aureus. Postoperatively, the patient developed trismus and granulation tissue, which were successfully managed with physical therapy and topical treatment. Symptoms gradually resolved over two months, with no recurrence at a seven-month follow-up.

Conclusions: This case highlights the diagnostic challenges of pediatric infections with atypical features, such as persistent swelling or failure to respond to therapy. Multimodal imaging played a crucial role in identifying the foreign body and guiding surgical intervention. A multidisciplinary approach, including antibiotics, surgery, and rehabilitation, is essential for managing complex infections and ensuring optimal outcomes in pediatric patients.