A patient with CSOM develops sudden onset facial palsy, high-grade fever with rigors, and a spiking temperature chart. He is drowsy but rousable. The MOST likely complication is:

• A Extradural abscess
• B Brain abscess
• C Subdural empyema
• D Sigmoid sinus thrombophlebitis ✓

Explanation

Sigmoid sinus thrombophlebitis classically presents with the picket-fence (hectic) spiking temperature pattern, rigors, and signs of raised intracranial pressure. It occurs when infected thrombus forms in the sigmoid sinus adjacent to the mastoid. Griesinger's sign (oedema over mastoid emissary vein) may be present. Immediate surgical drainage and anticoagulation are required.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.