Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio.
Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio.
J Emerg Med. 2023 Jul;65(1):e31-e35. doi: 10.1016/j.jemermed.2023.03.062. Epub 2023 Mar 17.
Orbital cellulitis is an infrequent but serious infectious complication of rhinosinusitis, most commonly seen in the pediatric population. Extension into the cavernous sinus, leading to further infection and thrombosis, is a rare but life-threatening complication. Although COVID-19 has been linked to an increased risk of venous thromboembolism, most cases involve extremity deep venous thrombosis or pulmonary embolism; reports of intracranial or jugular system thrombosis are rare.
We describe a case of a 17-year-old female patient with no significant medical history or thrombotic risk factors found to have orbital cellulitis and severe pansinusitis, complicated by multiple venous thromboses in the head and neck requiring emergent surgical intervention and pediatric intensive care admission. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Extensive head and neck venous thrombosis and intracranial abscesses are rare complications of pansinusitis and orbital cellulitis, and the thrombotic complications of COVID-19 are well documented. A delay in diagnosis and treatment can lead to potentially devastating consequences.
眶蜂窝织炎是一种罕见但严重的鼻旁窦炎感染并发症，最常见于儿科人群。扩展到海绵窦，导致进一步感染和血栓形成，是一种罕见但危及生命的并发症。虽然 COVID-19 与静脉血栓栓塞风险增加有关，但大多数病例涉及四肢深静脉血栓形成或肺栓塞;颅内或颈内系统血栓形成的报告很少见。
我们描述了一例 17 岁女性患者，无明显病史或血栓形成危险因素，患有眶蜂窝织炎和严重的全鼻窦炎，并伴有头颈部多处静脉血栓形成，需要紧急手术干预和儿科重症监护病房入院。为什么急诊医生应该了解这一点？：广泛的头颈部静脉血栓形成和颅内脓肿是全鼻窦炎和眶蜂窝织炎的罕见并发症，COVID-19 的血栓并发症已有充分记录。诊断和治疗的延迟可能导致潜在的灾难性后果。
