A Case of Bilateral Cavernous Sinus Thrombosis with Intraorbital Abscess.

Koo, Nam Kyun; Kim, Jin Hee; Lee, Se Youp

Case Report

Journal of the Korean Ophthalmological Society 2005;46(4):731-735.
Published online April 30, 2005.

A Case of Bilateral Cavernous Sinus Thrombosis with Intraorbital Abscess.

¹Department of Opthalmology, College of Medicine, Keimyung University, Daegu, Korea. lsy3379@dsmc.or.kr
²Department of Radiation Oncology, College of Medicine, Keimyung University, Daegu, Korea.

안와내 농양을 동반한 양측 해면정맥굴혈전증 1예

구남균¹,김진희²,이세엽¹

Department of Opthalmology, College of Medicine, Keimyung University¹, Daegu, Korea Department of Radiation Oncology, College of Medicine, Keimyung University², Daegu, Korea

Correspondence: Nam-Kyun Koo, M.D.¹

Abstract

PURPOSE
We report a case of bilateral cavernous sinus thrombosis and unilateral intraorbital abscess in a patient suffering proptosis, a limitation of ocular movement, and visual disturbance. METHODS: After several days of febrile and chilling sensation, a 49-year-old man suffered from vision loss, a limitation of ocular movement in all directions, proptosis in the right eye and mild abduction limitation in the left eye. Brain MRI, indicated inflammation in the bilateral cavernous sinuses and intraorbital abscess in the right eye, leading to a diagnosis of cavernous sinus thrombosis. Systemically, the patient was treated with antibiotics and steroid injection. For intraorbital abscess, aspiration and antibiotics injection were administered locally. The patient improved overall and the abscess size decreased. Blood culture showed alpha-hemolytic Streptococcus. The Gram stain of the specimen from the intraorbital abscess revealed Gram-positive cocci but no specific strain was cultured. RESULTS: We believe that proptosis in the right eye, intraorbital abscess, limitation of ocular movement, retinal hemorrhage, and optic atrophy were due to alpha-hemolytic Streptococcus, which had spread to the cavernous sinus and right orbit through the vascular system. CONCLUSIONS: We report a case of bilateral cavernous sinus thrombosis and intraorbital abscess in the right eye in a patient who suffered from sepsis caused by alpha-hemolytic Streptococcus.

Key Words: alpha-hemolytic Streptococcus;Cavernous sinus thrombosis;Intraorbital abscess