Cerebral venous sinus thrombosis secondary to nasopharyngeal abscess with Klebsiella pneumoniae infection in an elderly patient with multiple comorbidities: a case report and literature review
Abstract
Background: Cerebral venous sinus thrombosis (CVST) is a rare but severe cerebrovascular disorder. While often associated with hypercoagulable states, infections, particularly those involving the head and neck region, can be a significant predisposing factor. Klebsiella pneumoniae is a known pathogen causing invasive syndromes, including liver abscesses and metastatic infections, but its association with nasopharyngeal abscess leading to CVST and cavernous sinus syndrome is exceptionally rare, especially in elderly patients with complex medical backgrounds.
Case presentation: We report the case of a 77-year-old Chinese male with a history of hypertension and type 2 diabetes (poorly controlled), who presented with a 27-day history of paroxysmal headache and 10 days of progressive lethargy and gait instability. He subsequently developed bilateral eyelid ptosis, eyelid edema, chemosis, and ophthalmoplegia. Imaging studies identified a nasopharyngeal abscess with associated cavernous sinus thrombosis. Microbiological analysis of nasopharyngeal abscess fluid and blood targeted next-generation sequencing (tNGS) confirmed Klebsiella pneumoniae as the causative organism. The patient was managed with a multidisciplinary approach involving prolonged intravenous antibiotic therapy (Initially, meropenem and teicoplanin were administered; subsequently, the antibiotics were switched to levofloxacin and piperacillin-tazobactam based on the results of antimicrobial susceptibility testing),…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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