Septic Bilateral Cavernous Sinus Thrombosis With Persistent Methicillin-Resistant Staphylococcus Aureus Bacteremia

Kotagiri, Rajesh; Saunders, Aaron T

doi:10.7759/cureus.8554

Cited by 2 publications

(2 citation statements)

References 6 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Throughout his hospital stay, the patient was on anticoagulant and antiplatelet therapy. Anticoagulation with unfractionated heparin or low-molecularweight heparin has only been shown to reduce morbidity, ophthalmoplegia, blindness, stroke, and seizures but not overall mortality [8]. The benefit would be to stop the progression of thrombosis, stop the spread of clots, and perhaps allow antibiotics to penetrate; the risk, on the other hand, would be systemic or intracranial bleeding or even the spread of septic emboli.…”

Section: Discussionmentioning

confidence: 99%

Septic Cavernous Sinus Thrombosis in a Young Male Presenting With Pneumothorax Secondary to Septic Pulmonary Emboli: A Case Report

Vempati¹,

Dixit²,

Miriyala³

et al. 2023

Cureus

View full text Add to dashboard Cite

Septic pulmonary embolism (SPE) is a rare complication that happens when infected thrombi from the original site of infection break off and travel to the pulmonary blood vessels, causing an infarction or an abscess. Cases were reported on SPE, with tricuspid or pulmonary valve endocarditis being the most common primary site, especially in intravenous drug abusers. There are, however, very few reports of SPE brought on by septic cavernous sinus thrombosis (CST). Here, we describe the case of an 18-year-old male who had a pustule on his left eyelid, after which he developed fever, spontaneous swelling of his left eye, followed by his right eye, along with bilateral proptosis and diplopia, and new-onset dyspnea. Auscultation revealed decreased breath sounds in the left lung fields. Magnetic resonance imaging (MRI) revealed cavernous sinus thrombosis. Blood cultures isolated Staphylococcus aureus species. High-resolution computed tomography (HRCT) revealed a left-sided pneumothorax with minimal pleural effusion and multiple nodules scattered among both lungs, suggesting septic pulmonary emboli. We report this case to convey how a minor lesion, that is, an eyelid pustule (stye), can get complicated and set off a spiral of events that takes an unexpected tangent, challenging physicians and necessitating a rigorous approach.

show abstract

Section: Discussionmentioning

confidence: 99%

Septic Cavernous Sinus Thrombosis in a Young Male Presenting With Pneumothorax Secondary to Septic Pulmonary Emboli: A Case Report

Vempati¹,

Dixit²,

Miriyala³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Staphylococcus aureus reportedly accounts for 60-70% of all septic cerebral sinus thrombosis. ( 14) Several case reports have detailed cavernous sinus thrombosis secondary to MRSA-related orbital infections with high rates of mortality and morbidity, including blindness and impaired ocular motility [20][21][22][23][24]. The clinical course of MRSA infections has been more aggressive compared to other microbial causes [5,10,25].…”

Section: Discussionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus-associated orbital cellulitis: a case series

et al. 2023

View full text Add to dashboard Cite

Purpose In recent years, methicillin-resistant Staphylococcus aureus (MRSA) orbital cellulitis (OC) has drawn increasing clinical and public health concern. We present a case series of MRSA OC encountered at four Australian tertiary institutions. Methods A multi-centre retrospective case series investigating MRSA OC in Australia from 2013 to 2022. Patients of all ages were included. Results Nine cases of culture-positive non-multi-resistant MRSA (nmMRSA) OC were identified at four tertiary institutions across Australia (7 male, 2 female). Mean age was 17.1 ± 16.7 years (range 13-days to 53-years), of which one was 13 days old, and all were immunocompetent. Eight (88.9%) patients had paranasal sinus disease, and seven (77.8%) had a subperiosteal abscess. Four (44.4%) had intracranial extension, including one (11.1%) case which was also complicated by superior sagittal sinus thrombosis. Empirical antibiotics, such as intravenous (IV) cefotaxime alone or IV ceftriaxone and flucloxacillin, were commenced. Following identification of nmMRSA, targeted therapy consisting of vancomycin and/or clindamycin was added. Nine (100%) patients underwent surgical intervention. Average hospital admission was 13.7 ± 6.9 days (range 3–25 days), with two patients requiring intensive care unit (ICU) admission due to complications related to their orbital infection. All patients had favourable prognosis, with preserved visual acuity and extraocular movements, following an average follow-up period of 4.6 months (range 2–9 months). Conclusion NMMRSA OC can follow an aggressive clinical course causing severe orbital and intracranial complications across a wide demographic. However, early recognition, initiation of targeted antibiotics and surgical intervention when required can effectively manage these complications and achieve favourable visual outcomes.

show abstract

Septic Bilateral Cavernous Sinus Thrombosis With Persistent Methicillin-Resistant Staphylococcus Aureus Bacteremia

Cited by 2 publications

References 6 publications

Septic Cavernous Sinus Thrombosis in a Young Male Presenting With Pneumothorax Secondary to Septic Pulmonary Emboli: A Case Report

Septic Cavernous Sinus Thrombosis in a Young Male Presenting With Pneumothorax Secondary to Septic Pulmonary Emboli: A Case Report

Methicillin-resistant Staphylococcus aureus-associated orbital cellulitis: a case series

Contact Info

Product

Resources

About