Right cavernous sinus thrombosis secondary to sphenoidal rhinosinusitis. Case report

Abstract

Acute bacterial rhinosinusitis is the infection of the nasal and paranasal mucous mem- brane, with symptoms such as nasal congestion, purulent rhinorrhea and fever, usually self-limiting. Cavernous sinus thrombosis (CST) is a rare complication, which is asso- ciated with sphenoid and ethmoid sinus involvement, clinically manifest with headache, fever, cranial nerve involvement and ocular symptoms. When suspected, imaging stu- dies will confirm the clinical impression. They will show abnormal flow parameters in the compromised cavernous sinus. The treatment has to start as soon as possible and consists in broad spectrum intravenous antibiotics, surgical drainage of the site of the infection and anticoagulation. We present a patient with a right CST secondary to a non- treated sphenoidal sinusitis, that responded favorably to treatment. The clinical and ma- nagement of this pathology is described, which presents a high morbidity and mortality that can be reduced considerably with an early and aggressive treatment.