Triangles

A middle aged male with a two day history of severe retro orbital pain and fever. Examination reveals Bilateral Proptosis- right more than left. The right eye is frozen and left eye has restricted abduction. There is a crusted lesion on his nose which the patient says is a “pimple “that he burst.

Examination reveals that the patient has right sided 2nd 3rd , 4th , 6th and ophthalmic branch of trigeminal deficits with left sided 2nd and 6th nerve pasly. Imaging further revealed bilateral superior ophthalmic vein and cavernous sinus thrombosis. His blood cultures revealed MSSA.

He was treated with appropriate antibiotics for the same and therapeutic anticoagulation. Patient showed dramatic response with same.

LEARNING POINTS

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Clinical anatomy and relevance of The dangerous triangle of the face.Septic cavernous sinus thrombosis- etiology and management.Evidence for anticoagulation in septic thrombophlebitis.