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Critical Care: Student/Resident Case Report Poster - Critical Care IV |

A Severe Case of Septic Cavernous Sinus Thrombosis Caused by a Rare Pathogen

Hemal Mehta, MD; Anthony Saleh, MD; Ravish Singhal, MD
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New York Methodist Hospital, Brooklyn, NY


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):442A. doi:10.1016/j.chest.2016.08.455
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SESSION TITLE: Student/Resident Case Report Poster - Critical Care IV

SESSION TYPE: Student/Resident Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: Cavernous Sinus Thrombosis (CST) is thrombophlebitis in the cavernous sinuses. Before the availability of antibiotics, this dramatic and lethal illness carried a 100% mortality, therefore, the onus is on the clinician to have early recognition of this disease and treatment options, which include antibiotics, anticoagulation, and surgery. Although there have been case reports of CST as a complication of paranasal sinusitis, otitis media, and pharyngitis in pediatric population, literature review reveals few cases of CST in adults causing multi-organ impairment similar to our patient. We report a case of CST causing cranial nerve palsy and internal carotid artery narrowing from ethmoid and sphenoid sinusitis secondary to Group C, Beta Hemolytic Streptococcus. This is a common flora of upper airways and skin and bacteremia is almost always seen in immunocompromised individuals and rarely seen in an immunocompetent patient like ours.

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