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September 1965

Cavernous Sinus Thrombosis: A Case Due to Penicillin-Resistant Staphylococcus Treated With Methicillin Sodium

Author Affiliations

From the Department of Medicine, Kimbrough Army Hospital, chief (Maj Cooper). Dr. Vinnick was formerly with the Department of Medicine, Kimbrough Army Hospital, and is now resident in medicine, Massachusetts Memorial Hospital, Boston. Col Overholt was formerly chief, General Medical Service, Walter Reed Army Medical Center, Washington, DC, and is now chief, Department of Medicine, Fitzsimons General Hospital, Denver.

Arch Otolaryngol. 1965;82(3):303-306. doi:10.1001/archotol.1965.00760010305018

ABOUT 900 cases of cavernous sinus thrombosis have been reported.1 The mortality prior to the antibiotic era approached 100%2 and has remained high, varying from 12% to 75%1,3 since the introduction of the antibiotics. The cavernous sinuses are spongy structures containing arteries, nerves, and a plexus of anastomosing venous channels. They line each side of the sella turcica and are united by the anterior and posterior intercavernous channels. The venous tributaries from the face, sinuses, mouth, throat, and ears do not contain valves and offer direct access to the cavernous sinuses in the event of an infection in any of the areas mentioned. The primary focus in more than one half of the patients is a facial furuncle. Infections of the sinuses account for 15%, while dental and middle ear infections are responsible for 7% and 8% respectively.3 The responsible organism is most frequently Staphylococcus aureus,

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