Persistent Fever in Bilateral Septic Cavernous Sinus Thrombosis: A Case Report.

Area of Science:

• Infectious Diseases
• Neurosurgery
• Otolaryngology

Background:

• Septic cavernous sinus thrombosis (SCST) is a rare but life-threatening condition.
• It often arises from infections spreading from the face, sinuses, or teeth.

Observation:

• A middle-aged man with a history of MRSA skin infections presented with fever, neck pain, and bilateral eye swelling.
• Imaging revealed MRSA bacteremia, extraocular muscle thickening, and air-fluid levels in the sphenoid sinuses.
• The patient's condition worsened despite aggressive antibiotic and anticoagulant therapy, with imaging showing extensive intracranial thromboses.

Findings:

• Surgical intervention by otolaryngology was performed due to lack of clinical improvement and persistent bacteremia.
• Post-surgery, the patient demonstrated significant improvement, highlighting the importance of source control.

Implications:

• This case underscores the critical role of surgical source control in managing SCST.
• Considering surgical options may be vital for preventing severe complications and improving outcomes in SCST patients.
• Early and aggressive management, including source control, is essential for this dangerous condition.