a Department of Pediatrics, Section of Infection , Taichung Veterans General Hospital , Taichung , Taiwan.
b Department of Medicine , Chung Shan Medical University , Taichung , Taiwan.
Infect Dis (Lond). 2017 Sep;49(9):641-646. doi: 10.1080/23744235.2017.1331465. Epub 2017 May 23.
Cavernous sinus thrombosis (CST) is a severe disease which can result from infection of any of the tissues drained by the cavernous sinus. We here review eight cases, including a 12-year-old girl, all secondary to sphenoid sinusitis. The clinical manifestations, laboratory data, imaging findings, pathogens, medications, surgical treatment and clinical outcomes were analyzed. All eight patients had headache and five of them fever. All cases were associated with one or more ophthalmic symptoms. In four cases, computed tomography/magnetic resonance imaging showed isolated sphenoid sinusitis. In three cases, streptococci were isolated from blood culture and two cases showed Staphylococcus aureus in blood and sinus cultures. In seven cases, surgery was undertaken. All eight subjects received antibiotics, and 5 were administered intravenous ceftriaxone and metronidazole. Six subjects received anticoagulation therapy and one received corticosteroids. No mortality was recorded. Three cases showed sequelae, including Lemierre syndrome, ophthalmic complaints, and cranial nerve paralysis. In conclusion, the management of CST should include intravenous antibiotic therapy, combined with endonasal sinus surgery.
海绵窦血栓形成（CST）是一种严重的疾病，可由海绵窦引流的任何组织感染引起。我们回顾了 8 例病例，包括 1 例 12 岁女孩，均继发于蝶窦炎。分析了临床表现、实验室数据、影像学表现、病原体、药物治疗、手术治疗和临床转归。所有 8 例患者均有头痛，5 例发热。所有病例均伴有 1 种或多种眼部症状。4 例 CT/MRI 显示孤立性蝶窦炎。3 例血培养分离出链球菌，2 例血和窦腔培养分离出金黄色葡萄球菌。7 例行手术治疗。所有 8 例患者均接受抗生素治疗，5 例患者静脉应用头孢曲松和甲硝唑。6 例患者接受抗凝治疗，1 例患者接受皮质类固醇治疗。无死亡病例。3 例出现后遗症，包括坏疽性口炎综合征、眼部不适和颅神经麻痹。总之，CST 的治疗应包括静脉用抗生素治疗，联合鼻内鼻窦手术。
