Thrombophlebitis of a Cavernous Sinus Following Extraction of Teeth: Cure With Penicillin and Heparin

Prior to the day of sulfonamide compounds in therapy, recovery from thrombophlebitis of a cavernous sinus was extremely rare.¹With the advent of these compounds reports of cures began to appear following the administration of sulfanilamide,²sulfapyridine,³sulfathiazole⁴and presumably sulfadiazine.⁵The use of anticoagulants, especially heparin, as adjuvant therapy seemed to enhance the value of the sulfonamide compounds,⁶but this was by no means proved.4fRecovery from cavernous sinus thrombophlebitis with penicillin therapy has been reported.⁷ The case reported now is noteworthy because (1) it illustrates again the danger of performing an operation on the maxilla and the palate in the presence of acute sinusitis, (2) thrombophlebitis of a cavernous sinus developed in the presence of an adequate sulfadiazine level in the blood and (3) a dramatic recovery followed the administration of penicillin and heparin. The paucity of reports of cases in which a patient was treated with penicillin