Orbital Cellulitis Complicated by Cerebral Vein Thrombosis and Meningitis in a Young, Healthy Adult

Abstract

Orbital cellulitis is a serious infection that can lead to severe complications if not promptly diagnosed and treated. This case report describes an unusual presentation of bilateral orbital cellulitis in a previously healthy 29-year-old female, complicated by cerebral vein thrombosis and meningitis. The patient's young age and lack of significant medical history make this case particularly noteworthy. Initially presenting with a local infection over the right nose that rapidly progressed to bilateral orbital cellulitis, subsequent imaging revealed extensive complications including bilateral cavernous sinus thrombosis, sphenoid sinusitis, and intracranial abscesses. Blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA), an uncommon finding in community-acquired orbital cellulitis. The patient underwent sinus endoscopy and bilateral sphenoidotomy, followed by a prolonged course of intravenous and oral antibiotics. This case highlights the potential for severe complications in orbital cellulitis, even in young, healthy individuals, and emphasizes the importance of prompt, aggressive treatment and multidisciplinary management. It is imperative for clinicians to maintain a high index of suspicion for atypical pathogens and rare complications in seemingly routine cases.