Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children

Frank, Garett S.; Smith, Jesse M.; Davies, Brett W.; Mirsky, David M.; Hink, Eric M.; Durairaj, Vikram D.

doi:10.1016/j.jaapos.2015.06.001

Cited by 31 publications

(18 citation statements)

References 16 publications

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“…Morbidity and mortality of paediatric CST have improved dramatically due to early recognition and aggressive therapy with antibiotics, anticoagulants and surgical intervention. The mortality rate is recently reported at 8% and most patients have no long-term lasting morbidity compared with the mortality rate of 15%–30% reported in earlier studies 7–9. High dose, broad spectrum parental antibiotic therapy should initially be directed towards the most common pathogens including Staphylococcus aureus , Streptococcus sp, Haemophilus influenzae , and anaerobic bacteria and should have good blood–brain barrier penetration.…”

Section: Discussionmentioning

confidence: 96%

“…If the paediatric patient has comorbidities, such as immunosuppression, diabetes or chronic steroid use or if the said patient fails to improve on initial antibiotic regimen, antifungal agents should be added. Fungal infections are associated with a worse outcome 7 9. Surgical intervention is critical and should include incision and drainage of the primary source of infection, such as FESS 1–3 7.…”

Section: Discussionmentioning

confidence: 99%

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Septic cavernous sinus thrombosis in a paediatric patient with undiagnosed thrombophilia

et al. 2019

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A previously healthy 8-year-old girl presented to the hospital with right periorbital and forehead swelling in the setting of a 1-week history of upper respiratory symptoms. Contrast-enhanced CT revealed pansinusitis with orbital and frontal abscesses and thrombosis of the anterior portion of the superior sagittal sinus. She was treated with surgical drainage, antibiotics and anticoagulants. After 2 days she developed cranial nerve (CN) VI palsy. Contrast-enhanced MRI revealed small epidural abscess, right-sided thrombi of the cavernous sinus, internal carotid artery and internal jugular vein, in addition to the superior sagittal sinus. Thrombophilia workup revealed heterozygosity for factor V Leiden. She underwent 6 weeks of parental antibiotic therapy, 3 months of anticoagulation therapy and 7 days of steroids. With treatment, her visual acuity returned to baseline, CN VI palsy resolved and repeat imaging showed resolution of thrombi and epidural abscess, but persistent narrowing of the internal carotid artery.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Septic cavernous sinus thrombosis in a paediatric patient with undiagnosed thrombophilia

et al. 2019

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“…Nasal septal abscess is curable without life-threatening complications, if it is promptly diagnosed and appropriately treated. However, late diagnosis and treatment is associated with serious complications, such as meningitis [ 6 ], intracranial sinus venous thrombosis [ 7 ], or even death [ 8 ]. Early diagnosis and immediate therapy is important to avoid a cosmetic nasal deformity or intracranial infection [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: a case report

et al. 2017

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Background: Orbital apex syndrome is a localized type of orbital cellulitis, where mass lesions occur at the apex of the cranial nerves. Although nasal septal abscess is uncommon, the organism most likely to cause nasal septal abscess is Staphylococcus aureus, and fungal septal abscesses are rare. Here we present an extremely rare and serious case of orbital apex syndrome secondary to fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes. Case presentation: A 59-year-old man with a 1-month history of headache underwent consultation in an otolaryngological clinic of a general hospital. He was diagnosed with nasal septal abscess and was treated with incisional drainage and 1 month of an antibiotic drip; however, his symptoms persisted. The patient later complained of diplopia due to bilateral abducens nerve palsy, and was then referred to the department of Otolaryngology -Head and Neck Surgery, Kobe City Medical Center General Hospital. The septal lesion was biopsied under general anesthesia, and S. apiospermum was detected using polymerase chain reaction. The patient was treated with an antifungal drug and surgical resection of the lesion was performed. Although the patient survived, he lost his eyesight. Conclusions: This patient represents the second reported case of nasal septal abscess and orbital apex syndrome caused by S. apiospermum. If not treated properly, septal abscess can be life-threatening and cause severe complications, such as ablepsia.

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“…По данным разных авторов, Staphylococcus aureusнаиболее частый инфекционный агент, который обнаруживается в 70% случаев [9,10], стрептококки -на втором месте. В последние годы чаще выявляется метициллинрезистентный Staphylococcus aureus (MRSA) [9][10][11][12].…”

Section: обзорыunclassified

Septic thrombus of the cavernous sinus

Berest

Mironets

2017

Vestn. otorinolaringol.

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Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children

Cited by 31 publications

References 16 publications

Septic cavernous sinus thrombosis in a paediatric patient with undiagnosed thrombophilia

Septic cavernous sinus thrombosis in a paediatric patient with undiagnosed thrombophilia

Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: a case report

Septic thrombus of the cavernous sinus

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