Septic cavernous sinus thrombosis: potentially fatal conjunctival hyperemia

Excerpt

A 54-year-old man was referred to our hospital with a several-week history of left ophthalmalgia. He was previously healthy apart from a 6-month history of gingivalgia. He presented with left-sided periorbital edema, injection, chemosis, proptosis, and decreased ocular movement (Fig. 1) following high fever, chills, and impaired consciousness. Contrast-enhanced head computed tomography (CT) and magnetic resonance imaging (MRI) revealed poor enhancement in the dilated left superior ophthalmic vein (Fig. 2a, b). The patient was diagnosed with septic cavernous sinus thrombosis (CST), which we treated using broad-spectrum antibiotics and anticoagulants. We attributed the CST to periodontitis considering the contaminated oral cavity. Clinical symptoms improved after treatment.

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