CT DEMONSTRATION OF PERIORBITAL GRAFT-VERSUS-HOST DISEASE

A 13-year-old boy who had undergone allogenic bone marrow transplantat ion for treatment of acute lymphocytic leukemia presented with bilater al periorbital rash and swelling. A CT scan showed bilateral symmetric periorbital swelling, subconjunctival fluid collections, and lacrimal gland enlargement. The patient was initially treated for presumed cel lulitis. However, persistently negative regional cultures (eye, nasoph arynx), a rapid response to immunosuppressive therapy after several da ys of nonresponse to intravenous antibiotic therapy, and, ultimately, results of a shin biopsy confirmed the diagnosis of acute graft-versus -host disease.