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Beyond the danger triangle: Septic cavernous sinus thrombosis following a temporal forehead furuncle
Amar Simha1, Selvam Suresh1, Bapanapalle Sreeveni2
1Senior Resident, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Tropical Doctor
|July 7, 2025
Summary
Septic cavernous sinus thrombosis (CST) is a rare but serious complication of facial infections. This case shows CST can occur from infections outside the usual
Area of Science:
- Infectious Diseases
- Neurology
- Ophthalmology
Background:
- Septic cavernous sinus thrombosis (CST) is a rare, life-threatening complication of facial infections.
- Typically, CST arises from infections in the midface 'danger triangle'.
- Lateral facial infections can also cause CST via deep venous pathways.
Purpose of the Study:
- To report a case of CST originating from an unusual infection site.
- To emphasize the importance of considering CST in diverse facial infection scenarios.
Main Methods:
- Case report of a previously healthy adolescent male.
- Clinical presentation: fever, bilateral orbital swelling, painful ophthalmoplegia after a temporal forehead furuncle.
- Diagnosis confirmed by Magnetic Resonance Imaging (MRI).
Main Results:
- MRI confirmed septic cavernous sinus thrombosis.
- Patient treated with intravenous ceftriaxone, vancomycin, and low molecular weight heparin.
- Successful clinical recovery was achieved.
Conclusions:
- CST should be considered even when the primary infection is outside the typical facial danger zone.
- Early diagnosis and appropriate antibiotic and anticoagulant therapy are crucial for favorable outcomes.
