Early cavernous sinus thrombosis following unilateral pansinusitis in a child.
Cavernous sinus thrombosis (CST) is a life-threatening entity with a high rate of mortality and lifelong morbidity. A strong clinical suspicion of the complication, early radiological detection and institution of timely, aggressive treatment are required to prevent permanent neurological disability. We present a 12-year-old girl with bilateral CST following unilateral pansinusitis. Clinical symptoms of headache and retro-orbital pain out of proportion to clinical signs on presentation prompted a suspicion of something beyond sinusitis and raised the clinical suspicion of cavernous sinus involvement. In spite of institution of an early medical treatment, she progressed to develop bilateral cranial nerve paresis. However, with the persistence of antibiotics and anticoagulation therapy, she was successfully managed with no residual neurological sequelae. The aim of this presentation is to highlight the grave consequences of cavernous sinus involvement following infections of paranasal sinus and the rare complete recovery from disability in this case.
Department of ENT, Command Hospital, Kolkata, West Bengal, India.
Ajay
A
Mallick
Department of ENT, Command Hospital, Kolkata, West Bengal, India.
Som Dutt
SD
Pathak
Department of Ophthalmology, Command Hospital, Kolkata, West Bengal, India.
Sandeep
S
Shankar
Department of Ophthalmology, Command Hospital, Kolkata, West Bengal, India.
Alok
A
Sati
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D020226:Cavernous Sinus Thrombosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D003389:Cranial Nerve Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D010291:Paresis / Q000209:etiology; D012852:Sinusitis / Q000150:complications*
D000900:Anti-Bacterial Agents; D000925:Anticoagulants