Facial Swellings
Facial swelling is a common presenting complaint. It may be generalised or localised. Many cases are due to trauma or infection but it may be a sign of systemic disease.
Causes
History
Traumatic
Usually obvious history of trauma. Swelling may be severe, with bruising and closure of the palpebral fissures. Insect bites may cause swelling due to allergy or infection. The patient may not be aware of an insect bite.
Infective
Erysipelas is an uncommon skin infection caused by streptococci. Pain and redness are apparent usually over the cheek. Pyrexia and malaise may occur. Dental infections are common (see Jaw pain and swellings, p. 262) and are often initially localised, but the side of the face may swell. There is severe associated throbbing pain. Sinusitis presents with constant unilateral pain over the frontal or maxillary sinuses. There is usually puffiness of the skin overlying the sinus. Parotitis presents with pain and swelling over the gland. If this is due to obstruction in the duct, the swelling occurs during eating, when the patient salivates, and regresses afterwards. Bilateral parotitis occurs with mumps.
