Cavernous Sinus Thrombosis

A 28-year-old woman treated with amoxicillin/clavulanate for Staphylococcus aureus rhinosinusitis diagnosed by culture of purulent discharge from her right sphenoidal sinus presented 2 weeks later with acute-onset severe bursting headache and vomiting; eye pain, redness, and swelling; chemosis with visible pulsation of ballooned-out palpebral conjunctivae; and proptosis of the right eye (video, beginning 00:06). MRI of the brain suggested right-sided cavernous sinus thrombosis (CST). She was diagnosed with septic cavernous sinus thrombosis and treated with antibiotics and anticoagulation with complete resolution of her symptoms and signs. For complete clinical details of the patient and her management see http://ja.ma/1XdFRD1.