Case of 11-year-old girl with acute otitis media with mastoiditis and sigmoid sinus thrombosis

• Published in: Pediatric Otorhinolaryngology Japan Vol. 40; no. 3; pp. 278 - 282
• Main Authors: Kamiyoshi, Naohiro, Kugo, Masaaki, Inoue, Shotaro
• Format: Journal Article
• Language: Japanese
• Published: Japan Society for Pediatric Otorhinolaryngology 2019; 日本小児耳鼻咽喉科学会
• Subjects: acute otitis media; antibiotics; anticoagulant therapy; sigmoid sinus thrombosis; S状静脈洞血栓症; 乳様突起炎; 急性中耳炎; 抗凝固療法; 抗菌薬
• ISSN: 0919-5858; 2186-5957
• DOI: 10.11374/shonijibi.40.278

Intracranial complications of acute otitis media are rare. However, the mortality rates are high and it may lead to neurological sequelae, early diagnosis and appropriate treatments are important. Herein, we report a case of acute otitis media complicated with mastoiditis and sigmoid sinus thrombosis. The patient was an 11-year-old girl who came to our hospital complaining of headache and vomiting. The day before admission, she was diagnosed with acute otitis media and was prescribed oral antibiotics. On admission, she was conscious and clear with no fever, and had no signs of meningeal irritation. We diagnosed right otitis media and mastoiditis by computerized tomography and started administration of broad-spectrum antibiotics. Next day, MRI revealed right sigmoid sinus thrombosis, and we started anticoagulant therapy with heparin. We performed anticoagulant therapy for 7 days, and administered antibiotics for 14 days. She discharged with no neurological sequelae. The thrombus disappeared on MRI of day 26. In conclusion, although sigmoid sinus thrombosis is rare, it should be considered as a possible cause of severe headache or vomiting with acute otitis media. In addition, treatment with broad-spectrum antibiotics and anticoagulant therapy might be useful for children with sigmoid sinus thrombosis.