Lateral sinus thrombosis after untreated otitis media - A clinical problem- again?

Antimicrobial agents have greatly reduced the incidence of intracranial com plications of infections of the middle ear and mastoid. Too many prescripti ons and overconsumption of antibiotics when otitis media is suspected has c aused resistance to many antibiotics, leading to a pronounced and justifiab le desire to reduce the widespread excessive use of antibiotics. The possib le untoward consequences of a too restricted antibiotic policy, however, is illustrated by the following case of a 14-year-old boy who, after non-trea tment of an ear infection, fell ill with one-sided headache and vomiting ca used by a lateral sinus thrombosis. After intravenous treatment with antibi otics, anticoagulants and ventilation of the middle ear, the infection was cured without complications. This case calls attention to the symptoms of o titic complications arising outside the temporal bone. The physician must a lways bear in mind the possibility of an unusual event. The general treatme nt of endocranial complications is outlined, giving details of the treatmen t given in this special case. We stress that one should not be too cautious in prescribing antibiotics in otitis media.