Septic Cavernous Sinus Thrombosis with Diffuse Spread Leading to Cerebral Ischemia

Sethi, Pooja; Jones, Scott T.; Valenzuela, Alejandra A.

doi:10.3109/01676830.2013.814686

Cited by 10 publications

(3 citation statements)

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“…The prevalence of MRSA in our patient cohort (2.6 %) is lower than carriage rates reported among hospitalized patients (3.4 and 7.3 % in two studies) [34, 35]. Since nasal colonization with S. aureus may lead to increased risk of other-site infections [11], and because NV can cause more serious complications (e.g., orbital abscesses, cavernous sinus thrombosis, necrotizing pneumonia) [20, 22, 36–38], we recommend that oncologists inspect patients’ anterior nares and question about symptoms, especially during treatment with EGFRIs among other targeted therapies. Associated medical and hematologic conditions, concomitant anticoagulant or inhalant use, current URTI, and smoking status did not appear to influence the NV development in our subset of patients, most likely due to their low frequency and low-risk characteristics.…”

Section: Discussionmentioning

confidence: 99%

Nasal vestibulitis due to targeted therapies in cancer patients

Ruiz

Belum

Boers–Doets

et al. 2015

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Background and purpose Cancer patients treated with targeted therapies (e.g., epidermal growth factor receptor inhibitors) are susceptible to dermatologic adverse events (AEs) including secondary skin infections. Whereas infections such as paronychia and cellulitis have been reported, nasal vestibulitis (NV) has not been described with the use of these agents. The aim of our study was to characterize NV in cancer patients treated with targeted therapies. Methods We utilized a retrospective chart review of cancer patients who had been referred to dermatology and were diagnosed with NV. We recorded data including demographics, referral reason, underlying malignancy, targeted anticancer regimen, NV treatment, and nasal bacterial culture results. Results One Hundred Fifteen patients were included in the analysis, of which 13 % experienced multiple NV episodes. Skin rash was the most common reason (90 %) for a dermatology referral. The most common underlying malignancies were lung (43 %), breast (19 %), and colorectal (10 %) cancer. Sixty-eight percent of patients had been treated with an EGFRI-based regimen. Nasal cultures were obtained in 60 % of episodes, of which 94 % were positive for one or more organisms. Staphylococcus aureus was the most commonly isolated organism [methicillin-sensitive S. aureus 43 %; methicillin-resistant S. aureus 3 %]. Conclusions We report the incidence and characteristics of an unreported, yet frequent dermatologic condition in cancer patients treated with targeted therapies. These findings provide the basis for additional studies to describe the incidence, treatment, and consequences of this event. A better understanding of NV would mitigate its impact on patients’ quality of life and risk for additional dermatologic AEs.

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Section: Discussionmentioning

confidence: 99%

Nasal vestibulitis due to targeted therapies in cancer patients

Ruiz

Belum

Boers–Doets

et al. 2015

Support Care Cancer

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“…The headache can occur alone or in conjunction with symptoms such as fever, lethargy, vomiting, or seizures. Examination findings may range from normal to focal neurologic deficits, vision loss, increased intraocular pressure, ptosis, impaired cognition, and coma, depending on the location and severity of the clot burden [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Dural sinus thrombosis identified by point-of-care ultrasound

Tricarico

MacKenzie

2018

Clin Exp Emerg Med

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Dural sinus thrombosis (DST), or cerebral venous thrombosis, is an uncommon cause of stroke. It has a variable presentation, and the symptoms and signs can be non-specific. The diagnosis of DST can be difficult to make and is often delayed or missed. Computed tomography venography or magnetic resonance venography are the typical imaging modalities used to diagnose DST. However, computed tomography venography and magnetic resonance venography both have limitation for emergency department patients. In this article, we report the use of point-of-care ultrasound to facilitate the diagnosis of DST.

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“…En sık tanımlanan protrombotik bozukluklar protein C, protein S, antitrombin III eksikliği, faktör V (Leiden) ve protrombin G20210A mutasyonlarıdır 8,9 . Birçok pediyatrik hasta multipl risk faktörlerine sahiptir. Antibiyotik tedavisi sayesinde septik ya da enfeksiyona bağlı trombozun sıklığı azalmakla birlikte, son çalışmalar septik trombozun büyük çocuklarda halen trombozun önemli bir kısmından sorumlu olduğunu göstermektedir 10 . Hastamızda da, otit zemininde gelişmiş mastoidit dışında etyolojiye yönelik incelemelerde bir patoloji saptanamamıştır.…”

Section: Discussionunclassified

A Case of Cerebral Venous Thrombosis Complaining Headache Without Any Neurological Sign

Özdemir¹,

Karavaizoğlu²,

Menekşe³

2015

Sakarya Med J

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ÖzetSerebral venöz tromboz klinik semptom ve bulgularının çeşitliliği nedeniyle başlangıçta tanı konulması zor olan bir hastalıktır. Yaklaşık % 30 olguda neden tespit edilemez. Klinik spektrum, izole baş ağrısından fokal defisit, nöbet ve komaya kadar değişebilir. Beynin magnetik rezonans görüntüleme (MRG) ve venografisi, ilk tercih edilecek görüntüleme yöntemleridir. Sadece hastaları bilgisayarlı tomografi (BT) çekerek değerlendirmek, vakaların atlanmasına neden olabilir. Burada 12 yaşında yaklaşık 3 haftadır baş ağrısı nedeniyle birden fazla dış merkez tarafından değerlendirilen ve beyin görüntülemelerinde patoloji bulunamayan bir hasta, beyin MRG'sinin kliniğimizde tekrar değerlendirilmesinde serebral venöz tromboz saptanması nedeniyle sunulmaktadır. Hastalığın klinik seyrinin değişken olması ve nonspesifik bulgularla başvurulabileceğinden tanı koymada güçlük yaşanabileceği unutulmamalıdır. (Sakarya Med J 2015, 5(4):215-219) Anahtar Kelimeler: Serebral venöz tromboz, baş ağrısı, çocuk, nöroradyolojik görüntüleme AbstractCerebral venous thrombosis is difficult to diagnose due to variety of clinical symptoms and signs in the beginning of the disease. Approximately 30% of the etiological reasons are still unknown. Clinical spectrum of the disease varies from isolated headache to focal deficit, seizure and even coma. Magnetic resonance imaging (MRI) and venography of brain are firstly preferred among the imaging techniques. Solely computed tomography (CT) imaging of brain might overlook the diagnosis of the case. Here, 12-year-old patient complaining headache for the last 3 weeks whom was evaluated by a few outside hospitals which could not find any pathology in brain images radiologically is presented; since he was diagnosed by cerebral venous thrombosis when re-evaluated by our radiology staff. The diagnosis of cerebral venous thrombosis might be missed and problematic when brain MRI and CT are evaluated by inexperienced medical personnel. (Sakarya Med J 2015, 5(4):215-219)

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Septic Cavernous Sinus Thrombosis with Diffuse Spread Leading to Cerebral Ischemia

Abstract: The acuity of onset coupled with the multiple risk factors for septic cavernous sinus thrombosis in this patient led to a fulminant presentation of this disease and ultimate poor outcome.

Cited by 10 publications

References 7 publications

Nasal vestibulitis due to targeted therapies in cancer patients

Nasal vestibulitis due to targeted therapies in cancer patients

Dural sinus thrombosis identified by point-of-care ultrasound

A Case of Cerebral Venous Thrombosis Complaining Headache Without Any Neurological Sign

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