In a patient with unsafe CSOM (cholesteatoma), intracranial complication develops with fever, severe headache, neck rigidity, and papilledema. CT shows sigmoid sinus thrombosis. The organism most commonly implicated in otogenic sigmoid sinus thrombosis is:

• A Streptococcus (anaerobic/micro-aerophilic) ✓
• B Pseudomonas aeruginosa
• C Staphylococcus aureus
• D Aspergillus fumigatus

Explanation

Otogenic sigmoid sinus thrombosis is most commonly caused by Streptococcus species, particularly anaerobic and micro-aerophilic streptococci, which gain access from the mastoid to the sigmoid sinus via direct erosion or via emissary veins. The classic presentation includes picket-fence (hectic) fever with rigors from septic emboli, and Griesinger's sign (edema over the mastoid due to thrombosis of the mastoid emissary vein). Pseudomonas is commonly isolated from CSOM but is less typically implicated in sigmoid sinus thrombosis compared to streptococci.

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.