Intracranial Sinus Thrombosis Inducing Papilledema and Proptosis as A Consequence of Severe Ethmoid and Sphenoid Sinusitis

A 16-year-old white male patient with acute onset of headache, fever following surfing on the Potomac River, evaluated at a local hospital with noncontrasted head cr which showed sphenoid/ethmoid sinusitis and started on oral antibiotics with no relief of his symptoms. The patient was re-evaluated 4 days later with contrasted head cT which showed extension of the sinusitis to involve the ethmoid and the sphenoid sinuses. He was admitted for intravenous antibiotics (clindamycin and ceftazidime), After 3 days he developed acute proptosis as, mild ocular pain, pain on eye movement.The patient was evaluated by an ophthalmologist who documented normal VA, motility and fundus exam. The diagnosis of orbital cellulitis was suspected. He was transferred to a tertiary care facility for further management. Past medical history significant for refractive error.