Bilateral cavernous sinus thromboses and intraorbital abscesses secondary to Streptococcus milleri☆
Section snippets
Case report
A 17-year-old previously healthy girl sought treatment at the Massachusetts Eye and Ear Infirmary for acute bilateral periorbital edema and decreased vision in the left eye for 24 hours (Fig 1). She had a 3-week history of headaches and nasal congestion. She failed to improve despite symptomatic therapy with analgesics and decongestants. Her symptoms worsened, and she experienced fever, neck pain and stiffness, and emesis. She was admitted to an outside hospital and started on intravenous
Discussion
Cavernous sinus thrombosis is a rare but potentially fatal complication of sinusitis and orbital cellulitis. Cavernous sinus thrombosis was first described by Bright in 1831 as a complication of epidural and subdural infections.2 Sphenoid and ethmoid sinusitis most often cause cavernous sinus thrombosis secondary to thrombophlebitis of the ophthalmic veins.1 Direct extension of an infected thrombus or dissemination of septic emboli may occur.3, 4 The sphenoid sinus lies in close proximity to
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Cited by (36)
Pediatric cavernous sinus and superior ophthalmic vein thrombophlebitis complicated by peri-venous orbital abscesses
2022, American Journal of Ophthalmology Case ReportsCitation Excerpt :Repeat imaging demonstrated a new superomedial collection concerning for an abscess, which was drained operatively. As in our patient, microbial analysis revealed Streptococcus milleri.5 Although in the setting of orbital cellulitis, another case report describes a patient with septic SOV thrombosis that developed a peri-SOV orbital abscess despite receiving antibiotic treatment.6
Cavernous sinus thrombosis during pregnancy
2017, Auris Nasus LarynxCitation Excerpt :Direct signs of CST include expansion of cavernous sinus, convexity of the normally concave lateral wall, abnormal irregular filling defects and asymmetry. Indirect signs may be the dilatation of the superior ophtalmic vein, exophtalmos and thrombi in the veins and cavernous sinus tributaries [4,11]. MRI can detect all stages of thrombus formation.
Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children
2015, Journal of AAPOSCitation Excerpt :Cultures from surgical specimens provided speciation information in 7 of our 9 patients (78%). Patients younger than 9 years of age usually have abscesses caused by a single organism, whereas older children have a higher frequency of polymicrobial infections and are more likely to harbor anaerobes.4 Overall, the most common organisms implicated in CST in the literature are Staphylococcus aureus and Streptococcus species.5
Periocular Infections
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious DiseasesStreptococcus anginosus Group
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious DiseasesCavernous sinus thrombosis as a result of a fungal infection: A case report
2013, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Before the advent of antibiotics, the mortality rate was as high as 100%, and it is now as low as 20%.6,8,10 The most common organisms isolated from these patients are staphylococcal and streptococcal species.1,5,7 Our case presents an unusual finding of CST due to aspergillosis.
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Manuscript no. 210979