Cavernous sinus thrombosis in two Papua New Guineans

Bilateral cavernous sinus thrombosis developed following minor forehead abrasions in two adult Melanesians in Papua New Guinea. In both cases diagnosis and the institution of appropriate treatment were delayed. The first patient died but the second survived with residual 6th cranial nerve palsy. Whenever this condition is suspected, because of the high case fatality rate, high-dose, intravenous antibiotic treatment which should include an agent effective against penicillinresistant staphylococci should be commenced without delay pending further investigation.