Unilateral orbital inflammation in a child after a jellyfish sting to the lower extremities

A 3-year 10-month-old child initially developed locally recurrent cutaneous eruptions within the first 2 weeks after sustaining a jellyfish sting to her lower extremities. After 5 asymptomatic weeks, she developed unilateral orbital inflammation that did not respond to systemic antibiotics, antihistamines, or steroids. Imaging revealed a rapidly growing mass of the right lacrimal gland. Urgent anterior orbitotomy was performed and the lacrimal gland was biopsied. Histopathologic diagnosis revealed sclerosing dacryodenitis consistent with orbital inflammatory syndrome and/or an immune response to an antigen challenge.