The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Cavernous sinus thrombosis complicating

necrotizing fasciitis

Photo by Professor Chua Chung Nen

A 23 year-old woman developed a left facial cellulitis which progressed relentlessly with necrosis. Debridement was performed on several occasions to halt the spread of the necrosis. The ophthalmic team was consulted 10 days after her admission because of left ptosis. Examination revealed poor ocular movement, an urgent CT scan revealed cavernous sinus thrombosis. She was given anti-thrombotic treatment by the medical team. The facial defect was later reconstructed with myocutaneous graft from the thigh by the plastic team.

 

Left ptosis.

 

Debridement of the left face to halt the spread of necrosis.

 

Poor ocular movement in all directions.

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