Septic thrombosis of orbital vessels due to cutaneous nasal infection.
The authors describe two cases of cutaneous nose infection that quickly spread and extended to the orbital venous complex. At first glance, the clinical presentation could be mistaken for a complicated sinusal infection; therefore, the evaluation of the sinuses, by means of physical examination and radiological investigation, was of great concern, showing that there was no important pathology in the sinuses. The CT scan and the color Doppler imaging (orbital ultrasound with Doppler) demonstrated, throughout the development of the disease, that the superior ophthalmic vein was affected in both patients and the cavernous sinus in one of them. On physical examination, chemosis of the conjunctiva, proptosis, and edema of the eyelids were prominent. Patients improved only after appropriate intravenous antibiotic therapy against staphylococcus (clindamycin) and corticosteroids, making one conclude that treatment of this disease should be initiated as soon as possible in order to decrease morbidity and mortality.
Sanchez
T G
TG
University of São Paulo School of Medicine, Brazil.
Cahali
M B
MB
Murakami
M S
MS
Butugan
O
O
Miniti
A
A
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000382:microbiology; D002481:Cellulitis / Q000382:microbiology; D002981:Clindamycin / Q000008:administration & dosage / Q000627:therapeutic use; D003229:Conjunctival Diseases / Q000382:microbiology; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004487:Edema / Q000382:microbiology; D005094:Exophthalmos / Q000382:microbiology; D005141:Eyelid Diseases / Q000382:microbiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009668:Nose Diseases / Q000382:microbiology*; D009915:Orbit / Q000098:blood supply* / Q000000981:diagnostic imaging; D010254:Paranasal Sinus Diseases / Q000382:microbiology; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000150:complications* / Q000188:drug therapy; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D014680:Veins
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D002981:Clindamycin; D003907:Dexamethasone