Pediatric emergency medicine trisk 0560 0560
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TABLE 25.3
LIFE-THREATENING CAUSES OF EDEMA
Localized
Allergic reaction with airway involvement
Medication induced angioedema
Hereditary angioedema
Cellulitis (with bacteremia)
Pit viper envenomation
Superior vena cava syndrome
Venous thrombosis
Cerebral edema
Reexpansion pulmonary edema
Generalized
Cardiac disease
Congestive heart failure
Pericardial effusion
Hepatic failure
Renal disease
Nephrosis
Nephritis
Sepsis
Localized bilateral upper eyelid edema (Hoagland sign) may be found in up to
50% of patients with Epstein–Barr virus (EBV) infectious mononucleosis. It is
not associated with any significant discomfort, is seen only for the first few days
of the illness, and is very specific for EBV so that it may be used to trigger further
laboratory evaluation to confirm the diagnosis.
When a child presents with severe or recurrent facial edema, especially if there
is a family history of similar symptoms, the diagnosis of hereditary angioedema
(see Chapter 85 Allergic Emergencies ) should be considered. When a patient
with localized edema of the head or neck presents for care, it is crucial that the
physician evaluate the child carefully for concurrent airway involvement. Facial
edema may also be caused by oral, dental, or sinus infections, including acute
