Frontal bone infarctions masquerading as bilateral orbital cellulitis in a patient with sickle cell disease

Somali, Abdulaziz Ismail Al; Helayel, Halah Bin; Jubran, Saeed A; Hariri, Jumana T; Ali, Hala

doi:10.4103/meajo.meajo_264_18

Cited by 1 publication

(3 citation statements)

References 7 publications

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“…Bilateral presentations are common ( Table 1 ), typically beginning unilaterally and progress to involve the opposite eye 14 . Such presentations could be due to either direct extension of the original site of occlusion or a second area of occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…Such presentations could be due to either direct extension of the original site of occlusion or a second area of occlusion. Notably, the two most commonly reported bones involved in bilateral presentations include the sphenoid (especially the greater wing 15 ) and the frontal bone 14 , both of which cross the midline, portending a contiguous extension of one process. The predominance of bilateral presentation further purported orbital infarction as a likely differential for our patient.…”

Section: Discussionmentioning

confidence: 99%

“…Initial imaging is often with CT to rule out an infective process; soft tissue swelling, fatty stranding, and fluid collections may be evident on such images 2 , 5 , 16 - 18 . Subsequent imaging includes MRI studies, with soft tissue findings including lateral wall fluid collections and edema with associated subperiosteal hematomas as well as lateral rectus muscle deviation 1 , 4 , 12 - 14 , 19 . More notably, bone findings include abnormal bone marrow signal, heterogenous enhancement of the marrow, and edema 5 , 18 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

More Than Meets the Eye: Orbital Swelling in an Adolescent with Sickle Cell Disease

Hicks¹,

Alsabri²,

Peichev³

et al. 2023

IJHOSCR

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Periorbital swelling is a clinical presentation with a broad differential and potentially deleterious consequence. Causes range from benign, including allergic reaction, to vision- and life-threatening, including orbital cellulitis and orbital infarction. The recent climate of SARS-CoV-2 has further complicated this differential, as the virus poses broad clinical presentations with new manifestations reported frequently. Rapid identification of the underlying etiology is crucial, as treatment approaches diverge greatly. Here, we report the case of an African American adolescent male with a history of homozygous sickle cell anemia presenting to an inner city hospital with bilateral periorbital swelling amid the coronavirus pandemic. Differentials including orbital cellulitis, COVID-MIS-C, orbital inflammatory syndrome, Hoagland sign, and orbital infarction secondary to sickle cell crisis are contrasted. We contrast our case with 12 case reports of orbital infarction in the setting of sickle cell crisis within the past 10 years, highlighting how these presentations, along with commonly reported findings of orbital infarction, compare with our patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%