ABSTRACT

Septic cavernous sinus thrombosis is an unusual and fatal pathology that can develop as a result of infectious or non-infectious conditions. There are very few reports of septic pulmonary emboli secondary to septic cavernous sinus thrombosis. We describe a case of a 31-year-old female patient who was immunocompromised due to methylprednisolone intake, had chronic pansinusitis and developed fever, headache, facial pain, eyelid swelling and proptosis with ophthalmoplegia in the left eye, loss of visual acuity. Computed tomography revealed thrombosis of the cavernous sinus, blood, sinus and pleural cultures isolated Streptococcus pneumoniae. The computed axial tomography scan revealed a right multiloculated empyema and a cavitated nodule corresponding to an infectious process, highlighting the presence of multiple nodules scattered between both lungs, suggestive of septic pulmonary embolism. A multidisciplinary strategy was implemented and after discharge, the patient is under surveillance with adequate recovery. This peculiar case shows the importance of a multidisciplinary approach to the management of this rare entity. We have noted all kinds of scenarios and the basis for this is a timely diagnosis and avoidance of possible complications to prevent serious and permanent consequences.

KEYWORDS

empyema, septic cavernous sinus thrombosis, septic embolism.

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