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2024, Number 3

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Neumol Cir Torax 2024; 83 (3)

Empyema secondary to a septic embolus in a patient with septic cavernous sinus thrombosis: a case report and review of the literature

Silva AJA, Morán CJM
Full text How to cite this article 10.35366/119447

DOI

DOI: 10.35366/119447
URL: https://dx.doi.org/10.35366/119447

Language: Spanish
References: 5
Page: 224-227
PDF size: 561.22 Kb.


Key words:

empyema, septic cavernous sinus thrombosis, septic embolism.

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.


REFERENCES

  1. Ali S. Cavernous sinus thrombosis: efficiently recognizing and treating a life-threatening condition. Cureus. 2021;13(8):e17339. Available in: https://doi.org/10.7759/cureus.17339

  2. Prabhu S, Jain SK, Dal Singh V. Cavernous sinus thrombophlebitis (sans thrombosis) secondary to odontogenic fascial space infection: an uncommon complication with unusual presentation. J Maxillofac Oral Surg. 2015;14(Suppl 1):168-172. Available in: https://doi.org/10.1007/s12663-012-0404-4

  3. Caranfa JT, Yoon MK. Septic cavernous sinus thrombosis: a review. Surv Ophthalmol. 2021;66(6):1021-1030. Available in: https://doi.org/10.1016/j.survophthal.2021.03.009

  4. Barranco-Trabi J, Scott JC, Fryer JM, Byrne M, Smith A, Song KH, et al. Unique presentation of septic cavernous sinus thrombosis and pulmonary embolism in the setting of reusable face covering. Case Rep Infect Dis. 2022;2022:3388537. Available in: https://doi.org/10.1155/2022/3388537

  5. Maqsood M, Imran Hasan Khan M, Yameen M, Aziz Ahmed K, Hussain N, Hussain S. Use of oral rivaroxaban in cerebral venous thrombosis. J Drug Assess. 2020;10(1):1-6. Available in: https://doi.org/10.1080/21556660.2020.1838769




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C?MO CITAR (Vancouver)

Neumol Cir Torax. 2024;83