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Pronunciations cavernous sinus thrombosis cellulitis computed tomography exophthalmos mucus thrombosis

An infection may spread from the sinuses, teeth, or bloodstream to the orbit. Infection of the orbit is called orbital cellulitis. Eye infections may develop after an injury. Symptoms include pain, a bulging eye, reduced eye movement, swollen eyelids, and fever. The eyeball has a swollen, indistinct appearance. Vision may be impaired.

Without adequate treatment, orbital cellulitis can lead to blindness. Infection can spread to the brain and spinal cord, or blood clots can form and spread from the veins around the eye to involve a large vein at the base of the brain (the cavernous sinus) and result in cavernous sinus thrombosis.

Cavernous Sinus Thrombosis Cavernous sinus thrombosis is the blockage of a large vein at the base of the brain (the cavernous sinus). It is usually caused by the spread of bacteria from a sinus infection or from an infection in the eye or around the nose. Thus, infections in the area around the nose to the rim of the eyes are always considered serious. Cavernous sinus thrombosis causes bulging eyes, severe headache, drowsiness or coma, seizures, a high fever, and abnormal sensations or muscle weakness in certain areas. To identify the bacteria, a blood sample and samples of fluid, mucus, or pus from the throat and nose are sent to a laboratory to be cultured. Computed tomography (CT) of the sinuses, eyes, and brain is usually performed. High doses of intravenous antibiotics are given immediately. If the condition does not improve after 24 hours of antibiotic treatment, the sinus may be drained surgically.

Diagnosis and Treatment

Doctors can usually recognize orbital cellulitis without using diagnostic tests. However, determining the cause may require further assessment, including examination of the teeth and mouth and x-rays or computed tomography (CT) of the sinuses. Often, doctors obtain samples from the lining of the eye and from the skin, throat, or sinuses as well as blood samples and send them to a laboratory for testing. The samples are cultured (to grow organisms) to determine where the infection that gave rise to the orbital cellulitis is located, which type of organism is causing the infection, and which treatment should be used.

Antibiotics are started before the results of the laboratory testing are known. Oral antibiotics are given for mild cases; intravenous antibiotics are given for severe cases. The antibiotic used at first may be changed if the culture results suggest that another drug would be more effective. Sometimes surgery is needed to drain a collection of pus (abscess) or an infected sinus.

Last full review/revision February 2003