title: Sterile subperiosteal fluid collections accompanying orbital wall infarction in sickle-cell disease.
abstract: Infarction of the orbital wall is an uncommon manifestation of sickle cell disease (SCD) that may mimic an infectious process. We report a patient with two separate orbital infarctions with different presenting symptoms involving different bones. Radiologic-guided sampling of a periosteal fluid collection in the first episode showed likely sterile inflammatory exudates. This case highlights the range of findings in orbital wall infarction in SCD as well as helpful clinical and imaging entities that may differentiate infarction from infection, allowing early diagnosis and appropriate management.
authors.affiliation: Department of Ophthalmology, Boston Children's Hospital Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston; Department of Ophthalmology, Harvard Medical School, Boston.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Huckfeldt
authors.affiliation: Department of Ophthalmology, Boston Children's Hospital Boston, Massachusetts; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston; Department of Ophthalmology, Harvard Medical School, Boston. Electronic address: ankoor.shah@childrens.harvard.edu.
authors.forename: Ankoor S
authors.initials: AS
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001826:Body Fluids; D019818:Clavulanic Acid / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004487:Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D009915:Orbit / Q000098:blood supply*; D010521:Periosteum / Q000473:pathology*; D013284:Stomatognathic System; D014057:Tomography, X-Ray Computed; D065093:beta-Lactamase Inhibitors / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D019818:Clavulanic Acid; D000658:Amoxicillin