Abstract
Septic thrombosis of the lateral sinus is a rare complication of otitis media; currently, it hasn't been found a case report of septic thrombosis of the lateral sinus in the medical literature of Colombia and, in addition to this, there is no consensus in the management of this pathology. Hence the importance of the present case, which is a 3-year-old male patient, who presented a clinical picture of 7 days of evolution characterized by right otalgia and fever, which after the administration of amoxicillin for 5 days got complicated and showed symptoms of severe headache, photophobia, nausea and vomiting.
Highlights
Acute otitis media (AOM) is a common disease in children populations, from 50% to 90% of the children from 0 to 5 years have suffered at least one episode of otitis media, peaking between the 6 to 12 months.Most of the time is a benign episode [1].Septic lateral sinus thrombosis (LST) is an intracranial complication of acute/chronic suppurative otitis media, which is between 2% to 20% of the intracranial complications
There are two pathophysiological mechanisms of the LST: One happens when acute otitis produces erosion of the bone that protects the sigmoid sinus and it causes an inflammation of the walls, which influences the formation of thrombi; the other one is the thrombosis that occurs as a result of the thromboembolic extension through the small veins
In the present case the patient showed otalgia, fever, headache, nausea and vomiting, which is consistent with a patient cohort, where most common signs and symptoms found were fever (88%), otalgia (77%) and ear discharge (55%), followed by neurological findings such as headache, abducens nerve palsy and papilledema (44%) [2]
Summary
Acute otitis media (AOM) is a common disease in children populations, from 50% to 90% of the children from 0 to 5 years have suffered at least one episode of otitis media, peaking between the 6 to 12 months. The Nuclear magnetic resonance (NMR) angiography is the most accurate technique, because it shows the vessels and the presence of thrombosis in them, an endoluminal subtraction corresponding to the thrombus and it helps to specify the size of the thrombus and check the integrity of the contralateral sigmoid sinus [1,5,7]. This complication is treated with antibiotic therapy targeting anaerobic and aerobic microorganisms, surgery (mastoidectomy) and, in some cases, anticoagulant. It hasn’t been found a case report of septic thrombosis of the lateral sinus in the medical literature of Colombia and, in addition to this; there is no consensus in the management of this pathology, the importance of the present case
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