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Staphylococcus aureus cavernous sinus thrombosis mimicking complicated fungal sinusitis
Murat Songu1, Nazan Can, Kazim Onal
1Department of Otorhinolaryngology, Dr. Behçet Uz Children's Hospital, Izmir, Turkey. songumurat@yahoo.com
Ear, Nose, & Throat Journal
|July 26, 2012
Summary
Septic cavernous sinus thrombosis, a rare infection, can cause vision loss. Early diagnosis and prompt treatment, including surgery and antibiotics, led to vision recovery in a challenging case.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Ophthalmology
Background:
- Septic cavernous sinus thrombosis is a rare but serious complication of head and facial infections.
- It can lead to significant morbidity, including vision loss and cranial nerve palsies.
Observation:
- A 45-year-old diabetic woman presented with symptoms mimicking fungal sinusitis, including fever, headache, and visual disturbances.
- Clinical signs included bilateral ptosis, double vision, reduced visual acuity, and restricted eye movements.
- Radiology confirmed cavernous sinus extension of sphenoid sinusitis with a fungus ball.
Findings:
- The patient experienced rapid vision deterioration, necessitating urgent surgical intervention.
- Bilateral ethmoidectomy and sphenoidectomy were performed.
- Postoperatively, visual acuity improved to 10/10 bilaterally, with full recovery of ocular function and no abducens nerve palsy at 2 months.
Implications:
- This case highlights the importance of a high index of suspicion for CST in patients with relevant infections and neurological signs.
- Prompt diagnosis via imaging, aggressive intravenous antibiotic therapy, and timely surgical debridement are essential for favorable outcomes.
- Otolaryngologists must be familiar with the clinical presentation and management of CST to prevent permanent sequelae.
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