https://scholars.lib.ntu.edu.tw/handle/123456789/589292
標題: | Septic cavernous sinus thrombosis: An unusual and fatal disease | 作者: | Chen H.-W. Su C.-P. Su D.-H. Chen H.-W. YEE-CHUN CHEN |
關鍵字: | Cavernous sinus thrombosis; Diabetes; Sinusitis; Zygomycosis | 公開日期: | 2006 | 出版社: | Scientific Communications International Ltd | 卷: | 105 | 期: | 3 | 起(迄)頁: | 203-209 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background: Septic cavernous sinus thrombosis (CST) is a rare and fatal disease. Clinical presentations in the early stage are nonspecific, and the sensitivity of cranial axial computed tomography (CT) with thick section is low. This study analyzed the clinical manifestation and neuroimaging findings in patients with septic CST in a medical center in Taiwan. Methods: This retrospective case series included nine patients with septic CST who had typical symptoms and clinical course, evidence of infection, and imaging studies which demonstrated cavernous sinus lesion, and who were treated between 1995 and 2003 at National Taiwan University Hospital. Results: Seven (77.8%) patients were more than 50 years old. Five (55.6%) had diabetes, and three (33.3%) had hematologic diseases. All cases were associated with paranasal sinusitis. The most frequent initial symptom was headache (66.7%), followed by ophthalmic complaints (diplopia or ophthalmoplegia, 55.6%; blurred vision or blindness, 55.6%), and ptosis (44.4%). Initial cranial images failed to identify CTS in all patients. Subsequent magnetic resonance imaging (MRI) or coronal contrast-enhanced CT (CECT) with thin section confirmed the diagnosis. Fungi were the most common pathogens (55.6%). The inhospital case-fatality rate was high (44.4%). Conclusion: Due to the high case-fatality rate and low yield rate of blood cultures, fungal CST should be suspected in an immunocompromised patient with ophthalmic complaints that progress from one eye to the other. Coronal thin-section CECT may be a useful alternative to MRI as a diagnostic modality for this condition. ?2006 Elsevier & Formosan Medical Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-33644513108&doi=10.1016%2fS0929-6646%2809%2960306-5&partnerID=40&md5=0284bf89ebf126d3d5e984c0cdd6a534 https://scholars.lib.ntu.edu.tw/handle/123456789/589292 |
ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(09)60306-5 | SDG/關鍵字: | amphotericin B; voriconazole; abscess drainage; adult; article; Aspergillus; blindness; blood culture; blurred vision; case study; cavernous sinus thrombosis; clinical article; clinical feature; computer assisted tomography; contrast enhancement; diabetes mellitus; diagnostic value; diplopia; disease association; disease course; fatality; female; headache; health care facility; hematologic disease; human; image analysis; immune deficiency; male; neuroimaging; nuclear magnetic resonance imaging; ophthalmoplegia; paranasal sinusitis; Peptostreptococcus; ptosis; retrospective study; sensitivity analysis; Staphylococcus simulans; Streptococcus constellatus; symptom; Taiwan; university hospital; Zygomycetes |
顯示於: | 醫學系 |
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