Eyelid Ecchymoses and Subconjunctival Hemorrhage in Pertussis

A previously healthy 10-year-old boy presented with a 4-day history of progressive eyelid bruising following weeks of intensifying dry cough. He had no history of trauma or clotting disorders and was up to date on vaccinations. Physical examination revealed bilateral eyelid ecchymoses and subconjunctival hemorrhage without ophthalmologic abnormalities. PCR testing of a nasopharyngeal swab confirmed Bordetella pertussis infection. These ocular findings were attributed to venous pressure elevations from paroxysmal coughing, a recognized complication of pertussis. The patient began clarithromycin therapy and showed ocular recovery after four weeks, though residual cough remained.

A previously healthy 10-year-old boy presented with a 4-day history of progressive eyelid bruising following weeks of intensifying dry cough. He had no history of trauma or clotting disorders and was up to date on vaccinations. Physical examination revealed bilateral eyelid ecchymoses and subconjunctival hemorrhage without ophthalmologic abnormalities. PCR testing of a nasopharyngeal swab confirmed Bordetella pertussis infection. These ocular findings were attributed to venous pressure elevations from paroxysmal coughing, a recognized complication of pertussis. The patient began clarithromycin therapy and showed ocular recovery after four weeks, though residual cough remained.