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Septic cavernous sinus thrombosis due to Streptococcus constellatus infection
Wen-Neng Chang1, Shang-Der Chen, Chun-Chung Lui
1Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|December 24, 2003
Summary
This case report details a rare instance of septic cavernous sinus thrombosis (CST) caused by Streptococcus constellatus in an adult male. Prompt diagnosis and penicillin G treatment led to a full recovery, highlighting effective management strategies for this serious infection.
Area of Science:
- Infectious Diseases
- Neurology
- Radiology
Background:
- Septic cavernous sinus thrombosis (CST) is a rare but life-threatening condition.
- Infections by Streptococcus constellatus are uncommon causes of CST, particularly in adults.
- This report addresses a unique case of adult septic CST due to S. constellatus.
Observation:
- A 39-year-old male presented with a 10-day history of headache, fever, and ophthalmoplegia, indicative of septic CST.
- Cranial magnetic resonance imaging (MRI) confirmed CST and revealed associated sphenoid sinusitis.
- Cerebral angiography corroborated the diagnosis of CST.
Findings:
- Blood cultures identified viridans streptococci, with further analysis confirming Streptococcus constellatus as the causative agent.
- Cerebrospinal fluid (CSF) analysis indicated meningitis.
- The patient had a history of chronic alcohol consumption, a potential predisposing factor.
Implications:
- This case expands the known spectrum of pathogens causing adult septic CST.
- Early diagnosis and appropriate antibiotic therapy, such as intravenous penicillin G, are crucial for favorable outcomes.
- Successful treatment resulted in lesion regression and sinusitis resolution, demonstrating the efficacy of medical intervention.