Cavernous sinus thrombosis complicating sinusitis

Michael L. Cannon, Benjamin L. Antonio, John J. McCloskey, Michael H. Hines, Joseph R. Tobin, Avinash K. Shetty

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Septic cavernous sinus thrombosis is a rare complication of paranasal sinusitis. Objective: To familiarize the clinician with the pathogenesis, diagnosis, and appropriate management of septic cavernous sinus thrombosis. Design: Case report and literature review. Setting: Pediatric intensive care unit in a university hospital. Patient: We present a 12-yr-old female with a 1 wk history of an upper respiratory tract infection with worsening dyspnea, cough, and swelling of the left eye progressing to adult respiratory distress syndrome. Secondary to the need for significant mechanical ventilatory support, venovenous extracorporeal membrane oxygenation was initiated. Computed tomography scan of the head and neck with contrast revealed bilateral cavernous sinus thrombosis. After broad-spectrum intravenous antibiotics and aggressive supportive care in conjunction with surgical intervention (maxillary sinus lavage and right orbital exploration) and anticoagulation therapy, the patient recovered. Blood cultures were positive for Viridans streptococcus. At discharge 3 wks later, the patient had improved, but had right-eye blindness. Conclusions: The diagnosis of septic cavernous sinus thrombosis requires a high index of suspicion and confirmation by imaging; early diagnosis and surgical drainage of the underlying primary source of infection in conjunction with long-term intravenous antibiotic therapy are critical for an optimal clinical outcome.

Original languageEnglish
Pages (from-to)86-88
Number of pages3
JournalPediatric Critical Care Medicine
Volume5
Issue number1
DOIs
Publication statusPublished - 01-12-2004
Externally publishedYes

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Cavernous Sinus Thrombosis
Sinusitis
Anti-Bacterial Agents
Viridans Streptococci
Pediatric Intensive Care Units
Extracorporeal Membrane Oxygenation
Maxillary Sinus
Therapeutic Irrigation
Adult Respiratory Distress Syndrome
Blindness
Cough
Respiratory Tract Infections
Dyspnea
Early Diagnosis
Drainage
Neck
Head
Tomography
Therapeutics
Infection

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Cannon, M. L., Antonio, B. L., McCloskey, J. J., Hines, M. H., Tobin, J. R., & Shetty, A. K. (2004). Cavernous sinus thrombosis complicating sinusitis. Pediatric Critical Care Medicine, 5(1), 86-88. https://doi.org/10.1097/01.PCC.0000102385.95708.3B
Cannon, Michael L. ; Antonio, Benjamin L. ; McCloskey, John J. ; Hines, Michael H. ; Tobin, Joseph R. ; Shetty, Avinash K. / Cavernous sinus thrombosis complicating sinusitis. In: Pediatric Critical Care Medicine. 2004 ; Vol. 5, No. 1. pp. 86-88.
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Cannon, ML, Antonio, BL, McCloskey, JJ, Hines, MH, Tobin, JR & Shetty, AK 2004, 'Cavernous sinus thrombosis complicating sinusitis', Pediatric Critical Care Medicine, vol. 5, no. 1, pp. 86-88. https://doi.org/10.1097/01.PCC.0000102385.95708.3B

Cavernous sinus thrombosis complicating sinusitis. / Cannon, Michael L.; Antonio, Benjamin L.; McCloskey, John J.; Hines, Michael H.; Tobin, Joseph R.; Shetty, Avinash K.

In: Pediatric Critical Care Medicine, Vol. 5, No. 1, 01.12.2004, p. 86-88.

Research output: Contribution to journalArticle

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Cannon ML, Antonio BL, McCloskey JJ, Hines MH, Tobin JR, Shetty AK. Cavernous sinus thrombosis complicating sinusitis. Pediatric Critical Care Medicine. 2004 Dec 1;5(1):86-88. https://doi.org/10.1097/01.PCC.0000102385.95708.3B