Concurrent Pansinusitis and Orbital Cellulitis Complicated by Extensive Head and Neck Venous Thrombosis in an Unvaccinated Adolescent Patient with COVID-19: A Case Report

Abstract

Background

Orbital cellulitis is an infrequent but serious infectious complication of rhinosinusitis, most commonly seen in the pediatric population. Extension into the cavernous sinus, leading to further infection and thrombosis, is a rare but life-threatening complication. While COVID-19 has been linked to an increased risk of venous thromboembolism, most cases involve extremity deep venous thrombosis and/or pulmonary embolism; reports of intracranial or jugular system thrombosis are rare.

Case Report

We describe a case of a 17-year-old female with no significant medical history or thrombotic risk factors found to have orbital cellulitis and severe pansinusitis complicated by multiple venous thromboses in the head and neck requiring emergent surgical intervention and pediatric intensive care admission.

Why Should An Emergency Physician Be Aware of This?

Extensive head and neck venous thrombosis and intracranial abscesses are rare complications of pansinusitis and OC, and the thrombotic complications of COVID-19 are well documented. A delay in diagnosis and treatment can lead to potentially devastating consequences.