Septic cavernous sinus thrombosis: case report of a sphenoidal sinusitis complication

Abstract

Introduction: Septic cavernous sinus thrombosis is a rare and difficult to suspect diagnosis. It has high rates of mortality and morbidity if not diagnosed and treated urgently. The most common etiology is an extension by contiguity, of an infectious process of the central face or perinasal sinus. The authors present a case report of a cavernous sinus thrombosis resulting from a complication of sphenoid sinusitis.

Methods: Case report

Results: Sixteen years old patient on antibiotic treatment for acute sinusitis, was attended at the Emergency Room for periorbital oedema. The CT scan showed a right ethmoido-maxillosphenoidal sinusitis with right cavernous sinus thrombosis con- firmed by Angio-CT with reduced f/ow of internal carotid artery and jugular vein, and right ophthalmic vein thrombosis. Was submitted to  sphenoidectomy  with  bilateral  ethmoidectomy, followed by antibiotic and anticoagulation treatment. He had a positive development, without sequelae, confirmed radiologically.

Conclusion: An early and a proper etiological diagnosis, followed by both an emergent medical and surgical treatment are critical in resolving the sphenoid sinusitis complicated by septic thrombosis of the cavernous sinus.