Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: A case report

被引：14
作者：
Allegrini D. [1 ]
Reposi S. [2 ]
Nocerino E. [3 ]
Pece A. [2 ]
机构：
[1] Eye Unit, Humanitas Gavazzeni Hospital, Humanitas University, Bergamo
[2] Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, Milan
[3] Radiology Department, San Paolo Hospital, University of Milan, Milan
来源：
Journal of Medical Case Reports | / 11卷 / 1期
关键词：
Cavernous sinus thrombosis; Odontogenic orbital cellulitis; Pulmonary embolism;
D O I：
10.1186/s13256-017-1309-0
中图分类号：
学科分类号：
摘要：
Background: This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis. Case presentation: A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis. Hematochemical and radiological examinations confirmed the cavernous sinus thrombosis and also showed septic pulmonary embolism. A blood culture indicated Streptococcus constellatus, which is a member of the Peptostreptococcus family, a saprophyte of the oral mucosa that can be pathogenic in immunocompromised persons. The odontogenic origin was then confirmed by dental radiography which showed a maxillary abscess. Her eye signs regressed after antibiotic and anticoagulant therapy. Conclusions: This complex case shows the importance of a multidisciplinary approach for the management of orbital cellulitis, for the prompt diagnosis and treatment of eye injuries and possible complications, so as to avoid serious and permanent sequelae. © 2017 The Author(s).
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