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Otolaryngology and Infectious Diseases · Journal article
Acta Medica Philippina · August 31, 2026
Early or partial results. Treat as a signal, not a conclusion.
This case report documents methicillin-resistant Staphylococcus aureus as an aetiological agent in superior ophthalmic vein thrombosis presenting with acute diplopia and esotropia in a young adult. The patient responded to empiric broad-spectrum therapy followed by targeted antimicrobial therapy (meropenem and vancomycin), suggesting but not proving a therapeutic pathway.
Case report. A 23-year-old male presenting to the emergency department with periorbital swelling, upper lip edema, and pustular lesions; diagnosed with superior ophthalmic vein thrombosis on MRI of the brain.. Intervention: Empiric therapy initiated with ceftriaxone, vancomycin, and metronidazole; anticoagulation with enoxaparin; subsequent therapy adjustment to meropenem and vancomycin after culture results.. n = 1.
23-year-old male presented with periorbital swelling, upper lip edema, and pustular lesions Sudden-onset horizontal diplopia and left eye esotropia developed during emergency department evaluation MRI confirmed left superior ophthalmic vein thrombosis
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This case illustrates that MRSA should be considered in the differential diagnosis of superior ophthalmic vein thrombosis, particularly in patients presenting with periorbital swelling and pustular lesions. However, as a single case with favorable outcome, it does not establish standard treatment protocols; clinical decisions should integrate this report with institutional guidelines and broader evidence on orbital infection management.
A single uncontrolled case report of MRSA-associated superior ophthalmic vein thrombosis with favourable outcome; raises awareness of a rare complication but provides no comparative evidence or generalizable treatment guidance.
As stated by the source record.
Quoted from the source exactly as published.
This case illustrates that MRSA should be considered in the differential diagnosis of superior ophthalmic vein thrombosis, particularly in patients presenting with periorbital swelling and pustular lesions. However, as a single case with favorable outcome, it does not establish standard treatment protocols; clinical decisions should integrate this report with institutional guidelines and broader evidence on orbital infection management.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Superior ophthalmic vein thrombosis (SOVT) is a rare but potentially life-threatening condition associated with significant risk of vision loss. It may arise from infectious or inflammatory orbital diseases, trauma, neoplasms, or hypercoagulable states, with Staphylococcus aureus being a common pathogen in orbital cellulitis. We report the case of a 23-year-old male who presented with periorbital swelling, upper lip edema, and pustular lesions. During evaluation in the emergency department, he developed sudden-onset horizontal diplopia and left eye esotropia. Magnetic resonance imaging (MRI) of the brain revealed thrombosis of the left superior ophthalmic vein. Empiric therapy with ceftriaxone, vancomycin, metronidazole, and enoxaparin was initiated. Wound and blood cultures later demonstrated heavy growth of methicillin-resistant Staphylococcus aureus (MRSA), prompting adjustment of antimicrobial therapy to meropenem and vancomycin. The patient subsequently improved and was discharged in stable condition. This case highlights the aggressive nature of MRSA infection and its potential to rapidly progress to orbital and intracranial complications such as SOVT. Early diagnosis, prompt imaging, targeted antimicrobial therapy, and timely intervention are essential to preserve vision and improve clinical outcomes.
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