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A 47-year-old man, with a 10-year history of alcohol consumption, presented with a left cheek swelling for 14 days following self-extraction of two teeth. On the day of admission, he developed a low-grade fever, delirium and left eye proptosis (figure 1A). Laboratory analysis showed a white cell count of 21.6×109 cells/L with 79.8% neutrophils. C-reactive protein was 26.3 mg/dL. Blood chemistries were within normal limits except creatinine 2.2 mg/dL and sodium 128 mmol/L. CT imaging of the brain revealed left superior and inferior ophthalmic vein engorgement (figure 1B), suspected cavernous sinus thrombosis (CST) related and a tissue swelling over left pterygoid muscles, consistent with an abscess (figure 1C, arrow). Chest X-ray revealed mass-like lesions over the left-upper and right-lower lung fields (figure 1D).
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement There are no data in this work.
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