We report the case of a young man with Fusobacterium necrophorum meningitis who developed bilateral carotid artery stenosis associated with thrombosis of the cavernous sinuses. Intraluminal clot was present in the region of the stenoses for which he was anticoagulated. The clinical presentation, problems with diagnosis, the use of anticoagulation and the need for prolonged treatment with metronidazole are discussed.
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