A healthy woman in her 60s presented acutely with right-sided periorbital edema, erythema, neck pain, and fever. Initial examination and investigations suggested right-sided orbital cellulitis with contralateral pansinusitis. Despite treatment with IV antibiotics, her symptoms worsened, and inflammatory markers continued to rise. Further imaging revealed thrombosis of the right superior ophthalmic vein extending into the cavernous sinus and right jugular vein. She underwent urgent left functional endoscopic sinus surgery followed by long-term anticoagulation. After six months of anticoagulation, she remained free of morbidity, and repeat imaging confirmed the resolution of the thrombosis.
Keywords: chronic rhino sinusitis; functional endoscopic sinus surgery (fess); peri-orbital cellulitis; pre-septal cellulitis; septic cavernous sinus thrombosis.
Copyright © 2024, Gunness et al.