Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA.
Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
BMJ Case Rep. 2021 Apr 22;14(4):e239359. doi: 10.1136/bcr-2020-239359.
The authors present a case of a 42-year-old previously healthy man who presented in sepsis, with right lateral gaze palsy. He was found to have bilateral cavernous sinus thrombosis (CST) and bilateral internal jugular thrombosis in the setting of bacteraemia. The patient was successfully treated and recovered from his illness after a protracted stay in the medical intensive care unit. We go over the treatment course and follow-up of this patient and discuss the need to have a high degree of clinical suspicion for CST and suppurative thrombophlebitis of the internal jugular veins. We also discuss the possible role of the Panton-Valentine leukocidin in causing thrombotic complications of bacteraemia.
作者报告了一例 42 岁的既往健康男性,以脓毒症表现,伴有右侧外展神经麻痹。患者血培养阳性,诊断为双侧海绵窦血栓形成(CST)和双侧颈内静脉血栓形成。该患者在重症监护病房治疗后,病情迁延,最终成功治愈。我们回顾了该患者的治疗过程和随访情况,并讨论了对 CST 和化脓性颈内静脉血栓形成的高度临床怀疑的必要性。我们还讨论了 Panton-Valentine 白细胞毒素在导致脓毒症血栓性并发症中的可能作用。