TY - JOUR T1 - Images of the month: Cavernous sinus venous thrombosis secondary to <em>Streptococcus milleri</em> maxillary sinusitis: An unusual cause of diplopia and headache JF - Clinical Medicine JO - Clin Med SP - e271 LP - e272 DO - 10.7861/clinmed.2020-0689 VL - 20 IS - 6 AU - Vanesa Anton-Vazquez AU - Robin Dru AU - Philip Rich AU - Mauricio Arias AU - Derek Macallan Y1 - 2020/11/01 UR - http://www.rcpjournals.org/content/20/6/e271.abstract N2 - Cavernous sinus venous thrombosis is an uncommon condition associated with high mortality rates if not recognised early. Symptoms include headache, visual loss, ophthalmoplegia, altered consciousness, proptosis and periorbital oedema. High-quality imaging is critical in early diagnosis and successful management. Primary infection (such as sinusitis) and possible complications (including meningitis) should be considered as potential aetiologies of cavernous sinus venous thrombosis, especially in those with a preceding history of localised infection. We present a case of a 50-year-old man with a bilateral cavernous sinus venous thrombosis with associated meningitis caused by Streptococcus milleri, secondary to maxillary sinusitis and otomastoiditis. He was successfully treated with antimicrobial treatment, surgical drainage and anticoagulation. ER -