Panda sign due to severe coughing

We present the case of a patient who developed periorbital ecchymosis (panda sign) following an exacerbation of asthma with severe coughing. There was no history of cranial trauma. Investigations for a structural or haematological cause were negative. The panda sign is typically seen following a base of skull fracture, but rarely reported due to severe coughing.

Keywords Panda sign, periorbital ecchymosis, raccoon eyes

Declaration of Interests No conflicts of interest declared.