Mandibular infarction and sterile subperiosteal fluid collection in patients with sickle cell disease: a report of two cases

Abstract

Vaso-occlusive crisis is the primary cause of morbidity and emergency department visits in patients with sickle cell disease (SCD) and may lead to acute bone infarction. Infarction most commonly affects the long bones; however, the craniofacial bones may also be involved. This case series describes two patients with SCD who developed mandibular infarction during vaso-occlusive crisis. Both patients presented with pain, trismus, fever, leukocytosis, elevated inflammatory markers, and imaging demonstrating an associated subperiosteal fluid collection. One patient underwent operative incision and drainage, while the other had complete resolution of symptoms with supportive management and no surgical intervention. This case series highlights that both operative and non-operative management strategies may result in symptom resolution, and the decision to surgically intervene should be individualized.