Septic cavernous sinus thrombosis secondary to halo vest pin site infection

•Cavernous sinus thrombosis is a potentially fatal scenario that should be added to the sequels of neglected halo pin site infection.•Diagnosis of septic CST requires a high degree of clinical suspicion. Painful proptosis after an infection at the territory of the face is Septic CST unless proven otherwise.•Institution of timely and aggressive treatments is required to prevent permanent neurological disability.•Recently, for those resistant to medical treatment, endovascular thrombolysis and recanalization have been proposed. Pin site infection is one of the frequent complications of the halo crown application which can be easily handled if addressed early. However, if this issue is neglected then serious infectious events may quickly transpire. Among all of the medical literature that the previously described scenarios have illuminated; we did not encounter a case involving infectious cavernous sinus thrombosis. The authors present a middle age man who arrived at our clinic with an acute left peri-orbital swelling, proptosis, and ophthalmoplegia which had occurred subsequent to an untreated halo pine site infection. With a diagnosis of septic cavernous sinus thrombosis (CST), appropriate antibiotics and anticoagulant therapies were administered. With the continuation of this conservative treatment regimen, he was successfully managed with no residual neurological consequences. Halo vest orthosis is an appropriately tolerated upper cervical spinal stabilizing device that is a commonly used worldwide. Septic CST that is secondary to a halo vest pin site infection has not been previously described within medical literature. In the case of a neglected pin site infection, with demonstration of ipsilateral eyelid edema and proptosis, septic CST should be immediately considered and treated vigorously with antibiotics and anticoagulant therapies.