Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report
A 24-year-old female presented with blurring of vision, chemosis, protrusion of eyeball, restriction of movements of right eye, numbness over the right side of the face with severe headache, stiffness of neck, and fever of 2 days duration. She gives a history of recent Covid-19 infection 3 weeks bac...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-07-01
|
| Series: | Assam Journal of Internal Medicine |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ajoim.ajoim_15_21 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849704374211706880 |
|---|---|
| author | Jayanta Thakuria Arvind Kumar Rohit Gupta Jacquiline D. Shira Dwijen Das |
| author_facet | Jayanta Thakuria Arvind Kumar Rohit Gupta Jacquiline D. Shira Dwijen Das |
| author_sort | Jayanta Thakuria |
| collection | DOAJ |
| description | A 24-year-old female presented with blurring of vision, chemosis, protrusion of eyeball, restriction of movements of right eye, numbness over the right side of the face with severe headache, stiffness of neck, and fever of 2 days duration. She gives a history of recent Covid-19 infection 3 weeks back. She was treated symptomatically and recovered fully. On examination, there was proptosis, chemosis, third, fourth, fifth, and sixth nerve palsy on the right side, and nuchal rigidity. She was started on broad spectrum antibiotics, analgesics, anticoagulant, and prophylactic antifungal thinking in line of post-Covid orbital cellulitis or mucormycosis. Her investigations revealed raised total leucocyte count and erythrocyte sedimentation rate with normal ultrasound abdomen and chest X-ray. Blood culture and culture of nasal swab and oral cavity for fungus were sterile. Contrast-enhanced magnetic resonance imaging brain, orbit, and sinus showed proptosis, myofascial edema, superior ophthalmic vein thrombosis, right cavernous sinus and deep cervical vein thrombosis, sphenoid and bilateral ethmoid sinusitis with narrow lumen of the internal jugular vein. She responded very well to the treatment. Her inflammatory parameters came down drastically and clinically, she started opening her eyes and ophthalmoplegia subsided within a week. By the 10th day she was asymptomatic. Repeat MRI showed reduction of proptosis, myofascial edema with partial recanalization of right superior ophthalmic vein, right cavernous sinus, and right deep cervical vein. She was discharged on injectable anticoagulant and antibiotics for another 10 days. |
| format | Article |
| id | doaj-art-e02c50e9b60a477299dbd2e3c284ce4b |
| institution | DOAJ |
| issn | 2278-8239 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Assam Journal of Internal Medicine |
| spelling | doaj-art-e02c50e9b60a477299dbd2e3c284ce4b2025-08-20T03:16:46ZengWolters Kluwer Medknow PublicationsAssam Journal of Internal Medicine2278-82392021-07-01112545710.4103/ajoim.ajoim_15_21Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case ReportJayanta ThakuriaArvind KumarRohit GuptaJacquiline D. ShiraDwijen DasA 24-year-old female presented with blurring of vision, chemosis, protrusion of eyeball, restriction of movements of right eye, numbness over the right side of the face with severe headache, stiffness of neck, and fever of 2 days duration. She gives a history of recent Covid-19 infection 3 weeks back. She was treated symptomatically and recovered fully. On examination, there was proptosis, chemosis, third, fourth, fifth, and sixth nerve palsy on the right side, and nuchal rigidity. She was started on broad spectrum antibiotics, analgesics, anticoagulant, and prophylactic antifungal thinking in line of post-Covid orbital cellulitis or mucormycosis. Her investigations revealed raised total leucocyte count and erythrocyte sedimentation rate with normal ultrasound abdomen and chest X-ray. Blood culture and culture of nasal swab and oral cavity for fungus were sterile. Contrast-enhanced magnetic resonance imaging brain, orbit, and sinus showed proptosis, myofascial edema, superior ophthalmic vein thrombosis, right cavernous sinus and deep cervical vein thrombosis, sphenoid and bilateral ethmoid sinusitis with narrow lumen of the internal jugular vein. She responded very well to the treatment. Her inflammatory parameters came down drastically and clinically, she started opening her eyes and ophthalmoplegia subsided within a week. By the 10th day she was asymptomatic. Repeat MRI showed reduction of proptosis, myofascial edema with partial recanalization of right superior ophthalmic vein, right cavernous sinus, and right deep cervical vein. She was discharged on injectable anticoagulant and antibiotics for another 10 days.https://journals.lww.com/10.4103/ajoim.ajoim_15_21blurring of visionchemosispost-covid patient |
| spellingShingle | Jayanta Thakuria Arvind Kumar Rohit Gupta Jacquiline D. Shira Dwijen Das Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report Assam Journal of Internal Medicine blurring of vision chemosis post-covid patient |
| title | Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report |
| title_full | Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report |
| title_fullStr | Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report |
| title_full_unstemmed | Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report |
| title_short | Post-Covid Cavernous Sinus Thrombosis with Peri-Orbital Cellulitis, Ophthalmoplegia, Deep Cervical Vein Thrombosis, Sinusitis in a 24-Year-Old Lady: A Case Report |
| title_sort | post covid cavernous sinus thrombosis with peri orbital cellulitis ophthalmoplegia deep cervical vein thrombosis sinusitis in a 24 year old lady a case report |
| topic | blurring of vision chemosis post-covid patient |
| url | https://journals.lww.com/10.4103/ajoim.ajoim_15_21 |
| work_keys_str_mv | AT jayantathakuria postcovidcavernoussinusthrombosiswithperiorbitalcellulitisophthalmoplegiadeepcervicalveinthrombosissinusitisina24yearoldladyacasereport AT arvindkumar postcovidcavernoussinusthrombosiswithperiorbitalcellulitisophthalmoplegiadeepcervicalveinthrombosissinusitisina24yearoldladyacasereport AT rohitgupta postcovidcavernoussinusthrombosiswithperiorbitalcellulitisophthalmoplegiadeepcervicalveinthrombosissinusitisina24yearoldladyacasereport AT jacquilinedshira postcovidcavernoussinusthrombosiswithperiorbitalcellulitisophthalmoplegiadeepcervicalveinthrombosissinusitisina24yearoldladyacasereport AT dwijendas postcovidcavernoussinusthrombosiswithperiorbitalcellulitisophthalmoplegiadeepcervicalveinthrombosissinusitisina24yearoldladyacasereport |