J Korean Ophthalmol Soc.  2022 May;63(5):467-471. 10.3341/jkos.2022.63.5.467.

Septic Cavernous Sinus Thrombosis Caused by Dental Infection

• Kim JS
• Yang JW
• Kim YJ

• KMID: 2530261
• DOI: http://doi.org/10.3341/jkos.2022.63.5.467

Abstract

Purpose
We report a case of bilateral septic cavernous thrombosis caused by a dental infection.
Case summary
A 58-year-old male was transferred to our hospital because of left-sided proptosis and eyelid swelling. The patient had fever and left temporal headache, which did not respond to oral and intravenous antibiotics. After experiencing a tooth injury while chewing hard food 3 months ago, the patient developed toothache and swelling around the tooth for which he did not take any treatment. The patient had left eyelid edema, ptosis, chemosis, and conjunctival congestion. The left eye movements were limited in all directions. Brain magnetic resonance imaging showed dilatation and thrombosis of the left superior ophthalmic vein and thrombosis of bilateral cavernous sinuses. The patient was treated with systemic antibiotics and anticoagulants. The blood culture showed growth of Parvimonas micra and Dialister Pneumosintes, which are common causes of dental infection.
Conclusions
Septic thrombosis of the cavernous sinus and superior ophthalmic vein thrombophlebitis can occur due to the spread of dental infection. Prompt diagnosis and treatment are important for rapid resolution of symptoms and good prognosis.

Keyword

Dental infection; Ophthalmic vein thrombophlebitis; Septic cavernous sinus thrombosis