title: Thrombophlebitis of the temporal vein as an extracranial complication of acute bacterial rhinosinusitis.
abstract: A 39-year-old white man presented with a swollen left upper eyelid secondary to progressive acute bacterial rhinosinusitis (ABRS). Physical examination found a 40% reduction in vision in the left eye and right-sided erythematous temporal swelling with tenderness to palpation. Computed tomography revealed the presence of an inflammatory lesion in the left orbit. Duplex ultrasonography demonstrated a thrombotic occlusion in the right superficial temporal vein (STV). For treatment of the complicated ARBS, the patient received intravenous antibiotics and underwent surgery. The STV thrombophlebitis was treated with low-molecular-weight heparin. Postoperatively, the patient recovered completely and his vision normalized; 10 days later, duplex ultrasonography showed a patent STV. The development of contralateral STV thrombophlebitis is conceivably facilitated by venous anastomoses of the scalp in the front of the head. As a result, embolic spread would be a possible complication of infectious ABRS foci communicating with intraorbital and pericranial veins. To the best of our knowledge, this is the first reported case of such a complication of ARBS in the literature.
authors: Department of Otolaryngology-Head and Neck Surgery, Bern University Hospital, Inselspital, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, CH - 3010 Bern, Switzerland. markus.huth@insel.ch.
authors: Markus E
authors: ME
authors: Huth
authors: Marco D
authors: MD
authors: Caversaccio
mesh_terms: D000038:Abscess / Q000209:etiology / Q000628:therapy; D000208:Acute Disease; D000328:Adult; D001424:Bacterial Infections / Q000150:complications*; D006801:Humans; D008297:Male; D009916:Orbital Diseases / Q000209:etiology / Q000628:therapy; D012220:Rhinitis / Q000150:complications*; D012852:Sinusitis / Q000150:complications*; D013702:Temporal Lobe / Q000098:blood supply*; D013924:Thrombophlebitis / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014680:Veins