↓ Figure 1. Brain and face MRI of the patient. (a) Osteomyelitis of the right mandible (red arrow). (b) Diffuse scalp swelling, frontoparietal regions, consistent with soft head syndrome (blue arrow). MRI: magnetic resonance imaging.
| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
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Case Report
Volume 17, Number 9, September 2026, pages 518-523
Mandibular Osteomyelitis and Acute Soft Head Syndrome in an Adolescent With Sickle Cell Disease
Figure
Table
| Test name | D1 | D2 | D3 | D4 | D5 | D6 | D7 | D8 | D9 | D10 | D11 | D12 | D13 | D14 | D28 (OPD follow-up) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; CRP: C-reactive protein; D: day; Hb: hemoglobin; Hb S: hemoglobin S; Hct: hematocrit; HPLC: high-performance liquid chromatography; LDH: lactate dehydrogenase; OPD: outpatient department; Plt: platelet count; WBC: white blood cell. | |||||||||||||||
| Hematology (reference range) | |||||||||||||||
| WBC (4–11 × 103/µL) | 8.1 | 15.9 | 12.8 | 8.48 | 6.71 | 7.06 | 7.05 | 7.0 | 6.9 | 6.8 | 6.7 | 6.6 | 6.5 | 6.4 | 5.61 |
| Hb (13–18 g/dL) | 9.5 | 8.46 | 7.82 | 8.68 | 9.60 | 10.1 | 9.80 | 9.5 | 9.2 | 8.90 | 8.60 | 8.30 | 8.00 | 7.80 | 8.4 |
| Hct (42–52%) | 28.4 | 25.3 | 24.5 | 27.0 | 29.3 | 31.0 | 30.0 | 29 | 28 | 27.0 | 26.0 | 25.0 | 24.0 | 23.0 | 31 |
| Plt (140–450 × 103/µL) | 497 | 236 | 231 | 242 | 221 | 248 | 245 | 240 | 235 | 230 | 225 | 220 | 215 | 210 | 232 |
| HPLC | |||||||||||||||
| Hb S (%) | 77.3 | 55.7 | 32.3 | 29 | 37% | ||||||||||
| Chemistry (reference range) | |||||||||||||||
| ALP (40–150 U/L) | 208 | 579 | 565 | 350 | 251 | 234 | 229 | 225 | 220 | 215 | 210 | 205 | 200 | 195 | 145 |
| ALT (7–40 U/L) | 140 | 125 | 92 | 52 | 39 | 31 | 28 | 25 | 23 | 21 | 19 | 17 | 15 | 13 | 12 |
| AST (5–34 U/L) | 98 | 184 | 119 | 48 | 30 | 30 | 29 | 27 | 25 | 23 | 21 | 19 | 17 | 15 | 7 |
| Total bilirubin (5–21 µmol/L) | 52.3 | 91 | 65 | 56.7 | 42.7 | 53.2 | 37.7 | 35.6 | 33.4 | 31.2 | 29 | 26.8 | 24.6 | 22.4 | 11 |
| CRP (Neg ≤ 5 mg/L) | 26 | 177.9 | 382.4 | 356.4 | 358.9 | 345.6 | 330.2 | 315.8 | 300.4 | 285 | 270.6 | 250 | 4 | ||
| LDH (125–220 U/L) | 721 | - | - | 2,505 | 1,658 | 1,520 | 1,433 | 1,356 | 1,300 | 1,250 | 1,200 | 1,150 | 1,100 | 1,050 | 238 |