The clinical characteristics, implicated pathogens and therapeutic outcomes of culture-proven septic cavernous sinus thrombosis
The clinical characteristics, implicated pathogens and therapeutic outcomes of culture-proven septic cavernous sinus thrombosis
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DOI：
10.1016/j.jocn.2019.07.022
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发表时间：
2019-10-01
影响因子：
2
通讯作者：
Chang, Wen-Neng
中科院分区：
文献类型：
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作者：
Hsu, Che-Wei;Tsai, Wan-Chen;Chang, Wen-Neng
在这项基于磁共振成像的研究中，我们研究了14名成年人（8名男性和6名女性；平均60.4岁；范围37-77岁）的临床特征，神经成像特征和治疗结果，具有粪便鼻窦血栓形成（CST）。在潜在条件中，有10例患有糖尿病，有13例伴有蝶鼻窦炎。头痛（n = 13）和眼科治疗（n = 13）是最常见的临床表现，其次是发烧（n = 9）和其他神经血管的体征和症状。从症状发作到诊断的持续时间为1至61天，症状发作后7天被诊断出诊断> 7天。海绵窦的膨胀是最常见的神经影像学特征，其次是海绵窦侧壁的凸（5）和海绵窦的填充缺陷（4）。葡萄球菌种（spp。）是最常见的病原体，其次是曲霉属。尽管有治疗，但患者中有7％（1/14）在医院死亡，幸存者中有67％（8/12）患有神经系统缺陷。发作至诊断的持续时间和偏瘫的存在是重要的预后因素。这些结果提供了这种不常见的传染性综合征的初步观点。还需要进一步的大规模研究来更好地描绘成人的化粪池CST。 （c）2019 Elsevier Ltd.保留所有权利。
In this magnetic resonance imaging-based study, we investigated the clinical features, neuroimaging features and therapeutic outcomes of 14 adults (eight men and six women; mean age 60.4 years; range 37-77 years) with septic cavernous sinus thrombosis (CST). Of the underlying conditions, 10 had diabetes mellitus and 13 had concomitant sphenoid sinusitis. Headache (n = 13) and ophthalmoplegia (n = 13) were the most common clinical presentations, followed by fever (n = 9) and other neuro-vascular signs and symptoms. The duration from the onset of symptoms to diagnosis ranged from 1 to 61 days, and more than 64% (9/14) of the septic CST patients were diagnosed >7 days after symptom onset. Expansion of the cavernous sinus was the most common neuroimaging feature, followed by convexity of the lateral wall of the cavernous sinus (5) and filling defect of the cavernous sinus (4). Staphylococcal species (spp.) was the most commonly implicated pathogen, followed by Aspergillus spp. Despite treatment, 7% (1/14) of the patients died in the hospital and 67% (8/12) of the survivors had neurological deficits. The duration of onset-to-diagnosis and the presence of hemiparesis were significant prognostic factors. These results provide a preliminary view of this uncommon infectious syndrome. Further large-scale studies are needed to better delineate septic CST in adults. (C) 2019 Elsevier Ltd. All rights reserved.