Orbital cellulitis, sinusitis and intracranial abnormalities in two adolescents with COVID-19

Roger E. Turbin, Peter J. Wawrzusin, Nicole M. Sakla, Christin M. Traba, Kristin G. Wong, Neena Mirani, Jean A. Eloy, Esther A. Nimchinsky

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.

Original languageEnglish (US)
Pages (from-to)305-310
Number of pages6
JournalOrbit (London)
Volume39
Issue number4
DOIs
StatePublished - Jul 3 2020

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Keywords

  • COVID-19
  • SARS-CoV-2
  • hemorrhage
  • orbital cellulitis
  • thrombosis

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