Septic cavernous sinus thrombosis: review of 13 cases focused in treatment and outcome

Introduction: Septic cavernous sinus thrombosis (SCST) is a rare complication associated with face and neck area infection. SCST is known for severe clinical presentation, often complicated and bad outcome. Till now, there are no randomized and controlled trials for management of this condition. Objective: To describe clinical characteristics, treatment and outcome of hospitalized confirmed SCST patients in Infectious Diseases Clinic in Prishtina, Kosovo. Methods: Clinical and laboratory data of 13 confirmed SCST cases treated in our institution, were reviewed retrospectively. Results: 13 cases of SCST in Infectious Diseases Clinic in Prishtina were treated between the Jan’ 1st 1991 and Dec’ 31st 2017. Five cases did not survive the disease (38.5%), three of 13 (23%) presented neurological complications at discharge from the hospital. 12 cases presented purulent meningoecephalitis and one sympathetic meningitis. In 12 (92.3%) cases, primary focus was in upper part of the face. Ethological agent was identified in 11 (84.6%), and in 8 (61.5%), it was Staphylococcus aureus. All patients were treated with anti edematous therapy, antibiotics, corticosteroids, whereas 7 (53.8%) patients were treated with anticoagulant therapy for four days. In one patient treated with anticoagulant therapy, hemorrhagic complications were seen. Contrast enhanced CT of head was 100% sensitive in detection of SCST, whereas contrast MRI confirmed SCST in only one of the four cases. Conclusions: The prognosis of SCST now a day is more favourable than before. Anti-coagulants seem to be a safe addition treatment to antibiotic, also in patients with SCST and central nervous system infection

Biography :

Shemsedin Dreshaj has completed his Medical Faculty in Prishtina, Kosovo in 1984. He has worked as a Specialist in Infectious Diseases at University Medical Centre Ljubljana, Slovenia in 1991and Subspecialist in CNS infections at Montefiore Medical Centre, NY, USA in 1996. He has completed his PhD in 2003 from Faculty of Medicine in Prishtina .He worked as Senior Infectious Diseases doctor in Infectious Diseases Clinic Prishtina in 1990, Head of Department for Neuroinfections (1992-2008), Head of ICU Department in Infectious Diseases Clinic (2008-2018). He was Head of Infectious Diseases Clinic (2006-2014), Vice Dean for academic affair’s (2009-2013), Medical Faculty in Prishtina. His research activities are focused on neuroinfection and neurological disorder. He has published more than 21 manuscripts in international journals, more than 40 proceedings and presented several oral or poster presentations in this field.

E-mail: shemsedin.dreshaj@uni-pr.edu

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