scholarly journals Allergic fungal sinusitis masquerading as cavernous sinus thrombosis

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
K V Chalam ◽  
Moises Enghelberg ◽  
Ravi K Murthy
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Clinical Feature ◽  
Fungal Sinusitis ◽  
Rare Presentation ◽  
Allergic Fungal Sinusitis ◽  
Cavernous Sinus Syndrome ◽  
Initial Work ◽  
Work Up ◽  
Timely Referral

Abstract Allergic fungal sinusitis (AFS), a noninvasive form of fungal sinusitis, is rarely seen in immunocompetent patients. Involvement of sphenoid sinus can result in proptosis and loss of vision. We report AFS masquerading as posterior cavernous sinus syndrome. A 59-year-old African-American man presented with right complete ptosis with ophthalmoplegia. After an initial work-up and imaging studies, patient underwent endonasal sphenoid surgery, which revealed characteristic ‘allergic fungal mucin’. Cavernous sinus syndrome is a rare presenting clinical feature of allergic fungal sinusitis. Ophthalmologists should be aware of this rare presentation of relatively common otorhinological disease for timely referral and appropriate management.

Lemierre’s syndrome with cavernous sinus thrombosis caused by dental infection

2021 ◽  
Vol 14 (3) ◽  
pp. e238521
Author(s):  
Peerawat Sukkul ◽  
Narongrit Kasemsap
Keyword(s):  
Internal Jugular Vein ◽  
Cavernous Sinus ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Cavernous Sinus Thrombosis ◽  
Lemierre’S Syndrome ◽  
Jugular Vein Thrombosis ◽  
Septic Emboli ◽  
Cavernous Sinus Syndrome ◽  
Lemierre's Syndrome

Lemierre’s syndrome is a rare multisystemic infection beginning in oropharynx commonly caused by oral anaerobic organisms and leading to internal jugular vein thrombosis with septic emboli. Here, we describe a 45-year-old woman with hypertension and unrecognised type 2 diabetes who presented to a community hospital with fever, double vision and septic shock. Examination showed neck pain aggravated by neck flexion, limited ocular movement of right lateral rectus, left medial rectus and left superior oblique and incomplete ptosis of the left eye. These symptoms were suggestive of bilateral cavernous sinus syndrome. CT of the brain showed bilateral proximal internal jugular vein and cavernous sinus thrombosis. CT angiography revealed septic emboli at both upper lungs. The patient had good improvement of neurological symptoms after dental extraction, intravenous antibiotic and anticoagulant.

Thunderclap headache

2020 ◽  
pp. 307-313
Author(s):  
Hille Koppen ◽  
Agnes van Sonderen ◽  
Sebastiaan F.T.M. de Bruijn
Keyword(s):  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Sudden Onset ◽  
Severe Headache ◽  
Thunderclap Headache ◽  
Cerebral Vasoconstriction ◽  
Initial Work ◽  
Life Threatening ◽  
Work Up ◽  
Neurologically Intact

Severe headache of sudden onset is relatively common, especially in emergency departments, and has an extensive differential. Neurovascular disorders often present with thunderclap headache. Although the initial work-up is focused to exclude subarachnoid haemorrhage, several other serious life-threatening disorders must be considered, such as cerebral venous sinus thrombosis and stroke. Furthermore, other causes like reversible cerebral vasoconstriction syndrome are recognized more and more. In this chapter the work-up of alert, neurologically intact patients presenting with an acute and severe headache, not related to trauma, will be described.

Acute sphenoid sinusitis leading to contralateral cavernous sinus thrombosis: a case report

2013 ◽  
Vol 127 (8) ◽  
pp. 814-816 ◽  
Author(s):  
S R Dyer ◽  
P J Thottam ◽  
S Saraiya ◽  
M Haupert
Keyword(s):  
Case Report ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Treatment Options ◽  
Cavernous Sinus Thrombosis ◽  
Sphenoid Sinusitis ◽  
Comprehensive Literature Review ◽  
Intravenous Antibiotics ◽  
Diagnostic Work ◽  
Work Up

AbstractIntroduction:The objective of this article was to report a case of isolated, acute, right-sided sphenoid sinusitis that progressed to contralateral cavernous sinus thrombosis in an 18-year-old male patient. We describe the atypical presentation of this case and discuss the relevant anatomy, pathogenesis, presentation, diagnostic evaluation and treatment.Case report:A case report of sphenoid sinusitis leading to contralateral cavernous sinus thrombosis was reviewed and presented along with a comprehensive literature review of the relevant anatomy, pathophysiology, microbiology, diagnostic work-up and treatment options.Conclusion:Cavernous sinus thrombosis is a rare clinical entity in the antibiotic era. However, limited sphenoid sinusitis may progress to cavernous sinus thrombosis in spite of maximal medical treatment, as highlighted in this case report. The mainstay of treatment includes early diagnosis allowing aggressive intravenous antibiotics and appropriate surgical management.

scholarly journals A rare presentation of orbital complication of invasive fungal sinusitis in an immunocompetent young boy-a rare case

2012 ◽  
Vol 8 (1) ◽  
pp. 48-51
Author(s):  
S Gaur ◽  
A Lavania ◽  
R Saxena
Keyword(s):  
Eye Movements ◽  
Maxillary Sinus ◽  
Young Male ◽  
Medial Wall ◽  
Fungal Sinusitis ◽  
Rare Presentation ◽  
Allergic Fungal Sinusitis ◽  
Surgery Patient ◽  
History Of ◽  
Ethmoid Sinuses

We present a case of allergic fungal sinusitis (AFS) in a 24 -year old man with history of left sided nasal obstruction and discharge since few years. Since few months he developed epiphora in the left eye associated with discomfort on eye movements. Patient was examined and CT with contrast was done. CT contrast showed an enhancing lesion in Left maxillary and ethmoid sinuses and erosion of the inferior bony wall of the orbit and medial wall of maxillary sinus. Though most patients of fungal sinusitis are immunocompromised but this patient was young male immunocompetent and made an unusual presentation with visual epiphora and painful eye movements. CT showed bony erosion of the Left inferior Bony wall of the Orbit and medial wall of Maxillary Sinus. After through examination and specific investigations, the patient was posted for surgery. We planed for Cald well –Luc’s Surgery and Endoscopic excision of the mass .Histological examination was reported as non malignant and microscopy showed Fungal Hyphae. After the surgery patient was discharged satisfactorily within couple of days and followed up regularly. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 48-51 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6826

Isolated Acute Sphenoid Fungal Sinusitis with Cavernous Sinus Thrombosis: Our Experience

2020 ◽  
Author(s):  
Amit Kumar ◽  
Kartikesh Gupta ◽  
Amit Kumar Tyagi ◽  
Saurabh Varshney ◽  
Niraj Kumar
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Fungal Sinusitis ◽  
Cavernous Sinus Thrombosis

Skull base osteomyelitis with secondary cavernous sinus thrombosis: a rare presentation of an animate foreign body in the ear

2021 ◽  
Vol 14 (1) ◽  
pp. e236723
Author(s):  
Anu Alex ◽  
Ajay Philip ◽  
Antony Abraham Paulose ◽  
Manju Deena Mammen ◽  
Anjali Lepcha
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Mouth Opening ◽  
Peritonsillar Abscess ◽  
Left Internal Carotid Artery ◽  
Cavernous Sinus Thrombosis ◽  
Rare Presentation ◽  
Left Frontal Lobe ◽  
Tertiary Centre ◽  
Sudden Decrease

A 42-year-old woman presented with fever, left ear pain, restricted mouth opening, difficulty in swallowing and inability to open her left eyelid for a period of 10 days. She was treated with antibiotics for the same at a local medical facility; however, a sudden decrease in her left eye vision prompted her to visit our tertiary centre. Her history was insignificant except for having multiple left ear syringing for an insect removal 10 days before onset of her current symptoms. On examination, she had ptosis of the left eye with chemosis, dilated pupil with only perception of light and restricted ocular mobility. Oral examination revealed trismus and bulge in the left peritonsillar region. Left ear examination revealed a large central perforation with mucopurulent discharge. CT of the neck with contrast demonstrated a collection in the left peritonsillar space with left internal carotid artery thrombosis. MRI of the brain with gadolinium revealed left cavernous sinus thrombosis with acute infarcts in the left frontal lobe. An emergency incision and drainage of the left peritonsillar abscess was performed. Culture grew broad aseptate fungal hyphae. Despite starting on antifungal therapy, she succumbed to her illness.

Cavernous sinus syndrome due to skull base metastasis: A rare presentation of hepatocellular carcinoma

2015 ◽  
Vol 63 (3) ◽  
pp. 437 ◽  
Author(s):  
RonaldA. B. Carey ◽  
SD Nathaniel ◽  
Sohini Das ◽  
Sniya Sudhakar
Keyword(s):  
Hepatocellular Carcinoma ◽  
Skull Base ◽  
Cavernous Sinus ◽  
Rare Presentation ◽  
Cavernous Sinus Syndrome

scholarly journals Cavernous Sinus Thrombosis in COVID-19 Associated Rhino-Orbital Mucormycosis: A Retrospective Audit in the First Wave of the Pandemic

2021 ◽  
Author(s):  
Stuti Chowdhary ◽  
Arun Alexander ◽  
Sivaraman Ganesan ◽  
Joe Vimal Raj ◽  
Sunitha Vellathussery Chakkalakkoombil ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Fungal Sinusitis ◽  
Cavernous Sinus Thrombosis ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Factors Affecting ◽  
Retrospective Audit ◽  
Laboratory Investigations

Abstract Purpose Cavernous sinus thrombosis (CST) is a complication of rhino-orbital-cerebral mucormycosis. The COVID-19 pandemic saw a rapid surge in the cases of acute fungal sinusitis, many of whom also had CST, further contributing to the ophthalmoplegia. This study was a retrospective audit of patients with mucormycosis treated during the first wave of the COVID-19 pandemic.Methods This study was conducted at a tertiary referral centre, and patients with rhino-orbital mucormycosis were included. Relevant laboratory investigations and CT scans of the paranasal sinuses and the cavernous sinus were analysed. Mortality at discharge was calculated.Results 61 cases of invasive mucormycosis were seen, of whom 20 were COVID-19 positive, and 21 had radiological evidence of CST. All patients in the study initially presented with clinical suspicion of mucormycosis, and COVID-19 was diagnosed during pre-admission investigations. 93% of patients had diabetes. A majority of patients received Amphotericin B and surgical debridement. The sphenoid sinus was involved in 32(52%) patients and the orbit in 34(56%). Factors affecting CST, such as platelet counts, were studied. Fifteen (25%) patients succumbed during their treatment.Conclusions 34.4% of patients with mucormycosis developed CST. Being COVID-19 positive led to an increase in mortality; however, there was no significant increase in death due to simultaneous COVID-19 and CST. Sinus involvement was not significant for the development of CST.

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