Help, very off puffy cheeks on tassled filefish

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Just got back from the weekend to find my filefish's face swollen. I've never seen anything like this before. The rest of the tank is healthy and stable.


Tank details
- 5 years old
- water quality all test fine, negligible po4, no3, etc
- corals all look fabulous
- other fish look perky
- string filtration, tank is always clean, barely even builds up a film of diatoms over two weeks
- filefish's has been in the tank for over six months and is well integrated into the population

Please help! TIA
 

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Breathing is normal. Fish we're QT'd with no new additions since he was added. This was an overnight swelling event, not a slow buildup.
 
If breathing is normal he's eating ok and there's no ammonia in the water I would probably dose stress guard and watch him. Stress gaurd has an anticeptic in it I really like the stuff.
 
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