Bilateral cavernous sinus and left dural sigmoid sinus thrombosis associated with extreme exertion: a case report

• Published in: Arquivos brasileiros de oftalmologia Vol. 84; no. 1; pp. 83 - 86
• Main Authors: Wern-Yih, Chong, Jan-Bond, Chan, Sudha, Menon, Norlelawati, Abu, Shatriah, Ismail
• Format: Journal Article
• Language: English
• Published: Brazil Conselho Brasileiro de Oftalmologia 01.01.2021
• Subjects: Adult; Cavernous Sinus - diagnostic imaging; Cavernous Sinus Thrombosis - diagnostic imaging; Cavernous Sinus Thrombosis - drug therapy; Cavernous Sinus Thrombosis - etiology; Exophthalmos - etiology; Humans; Male; OPHTHALMOLOGY; Orbital Cellulitis; Physical Exertion; Young Adult; Cavernous sinus thrombosis; Exercise; Physical training; Orbital cellulitis, Immunocompetence; Imunocompetência; Exercício físico; Celulite orbitária; Trombose do corpo cavernoso
• ISSN: 0004-2749; 1678-2925; 1678-2925
• DOI: 10.5935/0004-2749.20210013

Septic cavernous sinus thrombosis is a rare but often debilitating and potentially fatal disease. We describe a case of bilateral orbital cellulitis with rapidly progressing cavernous sinus thrombosis and left sigmoidal sinus thrombosis in an immunocompetent 20-year-old military man who had undergone intensive physical training. The patient presented with rapid painful swollen left eye for 2 days. The examination results were gross proptosis with total ophthalmoplegia. He was treated with intravenous antibiotics and corticosteroid. At 1 week, visual acuity improved to 20/20 OU, with a normal intraocular pressure. There was a significant improvement in proptosis. The ocular motility of the right eye was fully restored, with slight residual ophthalmoplegia in the left eye. There was no residual illness or recurrence of illness at 3 months' follow-up.