Question
A 22-year-old man with a history of repeated pain over the medial canthus and chronic use of nasal decongestants presents to the outpatient department with high-grade fever and chills, headache, and bilateral proptosis. On eliciting a further history, it is brought to light that the proptosis began in the right eye, and a few days later, the left eye was also affected. Which of the following is the most probable diagnosis?
| A. |
Orbital cellulitis
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| B. |
Panophthalmitis
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| C. |
Cavernous sinus thrombosis
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| D. |
None of the above
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Show Answer
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Correct Answer � C
Explanation
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Explanation:
- Pain over the medial canthus and use of nasal decongestants indicate that the patient was suffering from sinusitis, which can spread to cause any of the options, i.e., orbital cellulitis, cavernous sinus thrombosis, or panopthalmitis.
- The differentiating feature here is the presentation pattern and bilaterality of the proptosis.
- In cavernous sinus thrombosis, proptosis is initially unilateral but soon becomes bilateral due to the spread of infection to the contralateral sinus through the intercavernous communication. Also, cavernous sinus thrombosis presents with high-grade fever with chills, rigor, and headache.
- On the other hand, orbital cellulitis and panophthalmitis are unilateral conditions.
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