Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

• Main Authors: Massimo Luca Castellazzi, Giada Maria di Pietro, Michele Gaffuri, Sara Torretta, Giorgio Conte, Francesco Folino, Sebastiano Aleo, Samantha Bosis, Paola Marchisio
• Format: Article
• Language: English
• Published: BMC 2020-09-01
• Series: Italian Journal of Pediatrics
• Subjects: Acute otitis media; Acute mastoiditis; Cerebral venous sinus thrombosis; Fusobacterium necrophorum; Children
• Online Access: http://link.springer.com/article/10.1186/s13052-020-00882-9

Abstract Background Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011. Case presentation The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient’s full recovery. Conclusion Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.