A 13-year-old boy presented to our hospital with a 1-week history of fever and headache. On physical examination, he was alert and febrile (40.5[degrees]C). He had no neck stiffness or abnormalities in eye movement or appearance, visual acuity or facial sensation. He had an elevated white blood cell count (27.2 [normal range 3.3-8.6] * [10.sup.9] /L, with 85% segmented neutrophils), C-reactive protein (114.5 [normal range < 1.5] mg/L) and D-dimer (28 200 [normal range < 1000] [micro]g/L). Cerebrospinal fluid analysis was normal. Noncontrast magnetic resonance imaging (MRI) showed opacification in both sphenoid sinuses, and contrast-enhanced MRI showed filling defects in both cavernous sinuses (Figure 1A). We diagnosed cavernous sinus thrombosis (CST) secondary to sphenoid sinusitis. Magnetic resonance angiography showed narrowing of both internal carotid arteries (Figure 2A). We started intravenous administration of ceftriaxone, meropenem and heparin, and later identified Hemophilus influenzae in...
Cavernous sinus thrombosis related to sphenoid sinusitis in a child.
From: CMAJ: Canadian Medical Association Journal(Vol. 193, Issue 20)
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 568 words
Lexile Measure: 1650L
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