<i>Aggregatibacter aphrophilus</i>-associated Sphenoid Sinusitis Causing Orbital Cellulitis, Meningitis, and Venous Sinus Thrombosis

We herein report an 81-year-old woman with no significant medical history who developed a fever, headache, and right eyelid swelling. Magnetic resonance imaging (MRI) showed eye proptosis, sphenoid opacity, enlarged cavernous sinus, and dilated right superior ophthalmic vein (SOV). Subsequent enhanced MRI revealed intraventricular debris and thrombosis in the right SOV and the left transverse and sigmoid sinuses. Blood cultures were positive for Aggregatibacter aphrophilus, as identified by mass spectrometry. The patient responded well to antibiotics, anticoagulants, and surgical drainage of sphenoid sinusitis. To our knowledge, this is the first case of A. aphrophilus sphenoid sinusitis causing orbital cellulitis, meningitis, and venous sinus thrombosis.