Danger Triangle of Face and Septic Cavernous Sinus Thrombosis

      A 52-year-old man was admitted due to high-grade fever with chills and cranial nerve deficits. Fifteen days prior to hospitalization, a furuncle had developed over the tip of the nose and had extended to involve the surrounding area and upper lip. He was prescribed oral antibiotics, after which the lesion had started healing. However, fever persisted, and 1 day prior to admission he noticed pain in his right eye and forehead, with drooping of the eyelid and diplopia (Figure 1). On examination, complete right ophthalmoplegia due to right lateral and medial rectus palsy was found (Figure 2A and 2B).
      Figure thumbnail gr1
      Figure 1A lesion in the danger triangle of the face, and ptosis of the right eye.
      Figure thumbnail gr2
      Figure 2(A) Right lateral rectus palsy. (B) Right medial rectus palsy.
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