Cavernous Sinus Thrombosis in a Three-Year-Old Male

Cavernous sinus thrombosis (CST) is a rare disorder that can follow head and neck infections such as acute sinusitis, peritonsillar abscess (PTA), otitis media, and mastoiditis. The clinical presentation is variable, making CST difficult to recognize at initial presentation. This case report presents a three-year-old otherwise healthy male who presented to the emergency department with two weeks of intermittent fever and rhinorrhea and one day of lethargy and left-sided ptosis. Evaluation and workup in the emergency department included computed tomography (CT) and magnetic resonance imaging (MRI), which revealed a right-sided PTA, pansinusitis, and CST with dural involvement. The patient underwent PTA drainage, bilateral ethmoidectomy, adenoidectomy, and maxillary antrostomy in the operating room. This report highlights the importance of recognizing this low-incidence, high-morbidity diagnosis in the younger pediatric population and initiating early intervention to improve patient outcomes.