# Bilateral cavernous sinus and left dural sigmoid sinus thrombosis associated with extreme exertion: a case report

## TL;DR

A 20-year-old military trainee developed rare sinus thrombosis after intense exercise, but recovered fully with treatment.

## Contribution

This case report highlights septic cavernous sinus thrombosis in an immunocompetent young adult linked to extreme physical exertion.

## Key findings

- The patient showed rapid improvement in visual acuity and proptosis after intravenous antibiotics and corticosteroids.
- Full ocular motility was restored in the right eye with minor residual issues in the left eye.
- No recurrence or long-term complications were observed at 3 months follow-up.

## Abstract

Septic cavernous sinus thrombosis is a rare but often debilitating and
potentially fatal disease. We describe a case of bilateral orbital cellulitis
with rapidly progressing cavernous sinus thrombosis and left sigmoidal sinus
thrombosis in an immunocompetent 20-year-old military man who had undergone
intensive physical training. The patient presented with rapid painful swollen
left eye for 2 days. The examination results were gross proptosis with total
ophthalmoplegia. He was treated with intravenous antibiotics and corticosteroid.
At 1 week, visual acuity improved to 20/20 OU, with a normal intraocular
pressure. There was a significant improvement in proptosis. The ocular motility
of the right eye was fully restored, with slight residual ophthalmoplegia in the
left eye. There was no residual illness or recurrence of illness at 3 months’
follow-up.