J Korean Ophthalmol Soc.  2004 Jul;45(7):1194-1199.

A Case of Bilateral Cavernous Sinus Thrombosis Secondary to Right Sphenoid Sinusitis

• Kang MH
• Lee YJ
• Shin SY

Abstract

PURPOSE
Cavernous sinus thrombosis (CST) is rare and fatal. We report a case of a 46-year-old female who had bilateral CST which spread from a right sphenoid sinusitis. METHODS: A 46-year-old female was medicated by high dose oral prednisolone for the right facial palsy. The next day she showed left eyelid ptosis, swelling and left oculomotor nerve palsy signs. 2 days later, the signs and symptoms were rapidly progressed to total ophthalmoplegia of both eyes. We evaluated the magnetic resonance image (MRI), cerebrospinal fluid (CSF), and blood culture findings. RESULTS: Brain MRI showed the right dominant both sphenoid sinusitis and bilateral CST. In the blood and CSF cultures, and the gram stains we found Staphylococcus aureus. Surgical drainage and antibiotic therapy were applied but the symptoms were not improved and she died of complications of subarachnoid hemorrhage. CONCLUSIONS: After high-dose oral steroid medication, CST occurred secondary to sphenoid sinusitis. We must be vigilant for CST as it is a rapidly progressing and fatal disease. and rule out other infection before using immunosuppressants.

Keyword

Cavernous sinus thrombosis; Immunosuppressants; Sphenoid sinusitis; Staphylococcus aureus

MeSH Terms

Blepharoptosis
Brain
Cavernous Sinus Thrombosis*
Cavernous Sinus*
Cerebrospinal Fluid
Coloring Agents
Drainage
Facial Paralysis
Female
Humans
Immunosuppressive Agents
Magnetic Resonance Imaging
Middle Aged
Oculomotor Nerve Diseases
Ophthalmoplegia
Prednisolone
Sphenoid Sinus*
Sphenoid Sinusitis*
Staphylococcus aureus
Subarachnoid Hemorrhage
Coloring Agents
Immunosuppressive Agents
Prednisolone