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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report two male adolescents who developed septic thrombosis of the cavernous sinuses after manipulation of a furuncle on the nasal dorsum. We noted in both patients, besides the clinical findings of a generalized infectious process, palpebral edema, proptosis, ptosis, altered pupillary reactivity and bilateral III, IV and VI nerve palsies, as well as dysfunction of the ophthalmic branch of the fifth cranial nerve. One of the patients also had bacterial meningitis. Their cerebral angiograms demonstrated narrowing of the intracavernous portion of both internal carotid arteries. They improved with the antimicrobial treatment, but were left with ptosis and ocular palsies as sequelae. The adequate management of facial furuncle to prevent such a serious complication is emphasized.
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PMID:[Septic thrombosis of cavernous sinuses. Report of 2 cases]. 141 52

Austrian syndrome is defined as the triad consisting of pneumonia, endocarditis and meningitis due to invasive Streptococcus pneumoniae infection. Few case reports have been reported since its first description in 1975 by Robert Austrian, mainly because it is rarely observed. Below we report the case of a 61 year-old male patient who presented with bacterial meningitis due S. pneumoniae followed by bacterial pneumonia and severe mitral regurgitation, associated with four vegetations on the atrial surface of the posterior mitral leaflet; in addition, there was rupture and prolapse of its middle scallop. The S. pneumoniae bacterium was isolated from cerebrospinal fluid and blood cultures. In consequence, the patient was given broad-spectrum antibiotic therapy and had an early valve replacement performed, obtaining a good clinical outcome. The key prognostic factor of the Austrian syndrome is determined by the damage of cardiac valves, particularly in patients with a compromised aortic valve; hence, it is necessary to identify the degree of valve injury and define surgical and antibiotic treatment on a timely fashion. However, in subacute, less frequent clinical cases where the mitral valve is the main valve compromised, usually a directed antibiotic therapy associated with advanced support measures are sufficient to control this infection.
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PMID:[Invasive Streptococcus pneumoniae infection (Austrian syndrome): a case report]. 2614 29

Meningitis or meningoencephalitis is a known complication of scrub typhus. Focal neurological deficits are rarely reported including hemiparesis, quadriparesis and isolated cranial nerve palsies. Here we are reporting a 24 years female who presented with fever, headache, ptosis, diplopia, facial deviation and unsteadiness of gait due to scrub typhus. Scrub typhus can present as acute or subacute meningitis complicated by multiple cranial palsies and cerebellitis. Hence it needs to be differentiated from acute bacterial meningitis and tubercular meningitis as delay in diagnosis and treatment will affect the morbidity and mortality.
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PMID:Scrub Meningitis Complicated by Multiple Cranial Nerve Palsies and Cerebellitis. 3157 66

A woman in her 60s with multiple sclerosis (MS) presented with right-sided ptosis, right sixth nerve palsy, right facial paraesthesia and signs of sepsis. She had a recent diagnosis of a dental abscess. Investigations revealed a right submasseter abscess leading to bacterial meningitis (Streptococcus intermedius) and a cavernous sinus thrombosis. She was managed in intensive care and underwent surgical drainage of the abscess. Anticoagulation for 6 months was planned. Cavernous sinus thrombosis is a very rare complication of a dental abscess, and even less frequently associated with submasseter abscesses. The case was complicated by a history of MS, to which the patient's symptoms and signs were initially attributed to. This case highlights the diagnostic pitfalls, and aims to enhance learning around similar cases. To the best of our knowledge, this is the first case report of a masseter/submasseter abscess leading to cavernous sinus thrombosis.
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PMID:Diagnostic difficulties in a patient with multiple sclerosis who presents with cranial nerve palsies: an unusual complication of dental work. 3312 21