Cavernous sinus thrombosis
Two hour history of blurred vision.
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Non-contrast CT demonstrates dense, distended bilateral superior ophthalmic veins. While there is some periorbital swelling, much more prominent swelling is seen within the left masticator space.
Findings are chiefly those of cavernous sinus thrombosis secondary to ascending deep facial infection. S. aureus was isolated as the causative organism.
Extra clinical information:
This patient had squeezed a pimple near her left nasolabial fold 3 days prior. Within an hour of presenting to the emergency department the patient had progressed from having slightly blurred vision to complete blindness and upper airway compromise. Unfortunately she died due complications of her infection.