Aggregatibacter aphrophilus-associated Sphenoid Sinusitis Causing Orbital Cellulitis, Meningitis, and Venous Sinus Thrombosis

We herein report an 81-year-old woman with no significant medical history who developed a fever, headache, and right eyelid swelling. Magnetic resonance imaging (MRI) showed eye proptosis, sphenoid opacity, enlarged cavernous sinus, and dilated right superior ophthalmic vein (SOV). Subsequent enhanc...

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Bibliographic Details
Published in:Internal Medicine 2024, pp.3965-24
Main Authors: Ohashi, Nobuhiko, Kawamura, Yoshino, Kamijima, Shota, Watanabe, Rie, Yamazaki, Shintaro, Matsushima, Nodoka, Tazawa, Ko-ichi
Format: Article
Language:English
Subjects:
Aggregatibacter aphrophilus
mass spectrometry
meningitis
orbital cellulitis
sphenoid sinusitis
venous sinus thrombosis
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Summary:We herein report an 81-year-old woman with no significant medical history who developed a fever, headache, and right eyelid swelling. Magnetic resonance imaging (MRI) showed eye proptosis, sphenoid opacity, enlarged cavernous sinus, and dilated right superior ophthalmic vein (SOV). Subsequent enhanced MRI revealed intraventricular debris and thrombosis in the right SOV and the left transverse and sigmoid sinuses. Blood cultures were positive for Aggregatibacter aphrophilus, as identified by mass spectrometry. The patient responded well to antibiotics, anticoagulants, and surgical drainage of sphenoid sinusitis. To our knowledge, this is the first case of A. aphirophilus sphenoid sinusitis causing orbital cellulitis, meningitis, and venous sinus thrombosis.
ISSN:0918-2918
1349-7235
1349-7235
DOI:10.2169/internalmedicine.3965-24