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Cavernous sinus thrombosis

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Two hour history of blurred vision.

Patient Data

Age: 25 years
Gender: Female
ct

Non-contrast CT demonstrates dense, distended bilateral superior ophthalmic veins.  While there is some periorbital swelling, much more prominent swelling is seen within the left masticator space.

Case Discussion

Findings are chiefly those of cavernous sinus thrombosis secondary to ascending deep facial infection. S. aureus was isolated as the causative organism.

Extra clinical information:

This patient had squeezed a pimple near her left nasolabial fold 3 days prior. Within an hour of presenting to the emergency department, the patient had progressed from having slightly blurred vision to complete blindness and upper airway compromise. Unfortunately, she died due to complications of her infection.

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