Bilateral cavernous sinus thrombosis by Zygomycetes and Enterococcus

Authors

  • Ricardo Matos Serviço de Otorrinolaringologia, Centro Hospitalar Universitário São João, EPE.; Unidade de Otorrinolaringologia, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Mafalda Sousa Serviço de Otorrinolaringologia, Centro Hospitalar Universitário São João, EPE, Portugal
  • Pedro Marques Serviço de Otorrinolaringologia, Centro Hospitalar Universitário São João, EPE.; Unidade de Otorrinolaringologia, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Fernando Vales Serviço de Otorrinolaringologia, Centro Hospitalar Universitário São João, EPE.; Unidade de Otorrinolaringologia, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Margarida Santos Serviço de Otorrinolaringologia, Centro Hospitalar Universitário São João, EPE, Portugal

DOI:

https://doi.org/10.34631/sporl.749

Keywords:

Acute rhinosinuitis, cavernous sinus thrombosis, endoscopic sinus surgery

Abstract

We present a case of acute rhinosinusitis complicated with bilateral thrombosis of the cavernous sinus in the adult, aim to alert to its clinical presentation and need for a high index of suspicion. We describe a 53-year-old man presenting with cough and rhinorrhea, with 15 days of evolution, followed by holocranial pulsatile headache, refractory to analgesia, as well as a paresis of the left abducens nerve. After contrastenhanced computed tomography of the cranio-encephalic structures and paranasal sinuses, complete opacification of every right paranasal sinus, associated with erosion of the cribriform plate, bilateral solution of continuity in the para-sphenoidal bone region, and filling defects within the cavernous sinuses were observed, suggesting bilateral cavernous sinuses thrombosis. After endoscopic sinus surgery and directed antibiotic treatment, a good clinical, analytical and imaging evolution were observed, and no neurological sequelae were present.

References

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Published

2019-11-24

How to Cite

Matos, R., Sousa, M., Marques, P., Vales, F., & Santos, M. (2019). Bilateral cavernous sinus thrombosis by Zygomycetes and Enterococcus. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 57(1), 31–36. https://doi.org/10.34631/sporl.749

Issue

Section

Case Report