Septic Lateral Sinus Thrombosis

Septic Lateral Sinus Thrombosis (SLST) is associated with mastoiditis, which is a complication of otitis media. Inflicted patients usually have following symptoms for several weeks before diagnosis is made.

• Fever
• Headache on the side of the ear infection
• Nausea and/or vomitting
• Vertigo
• Photophobia (fear and avoidance of lighting)
• Neck stiffness

Doctors usually suspect SLST when they see evidence of otitis media, along with the swelling of the area that is immediately behind the affected outer ear. The existence of sixth nerve dysfunction even raises strong suspicion of SLST. An MRI will help make the diagnosis of SLST.

MRI shows lateral sinus thrombosis on the left side

Initial treatment requires immediate IV antibiotic therapy that is a combination of ceftriaxone, metronidazole, and vancomycin. Doctors may adjust antibiotics in accordance with other available laboratory results.

If inflicted patients still have fever within 12-24 hours following the initiation of appropriate antibiotics, doctors usually proceed with radical mastoidectomy with drainage of pus and infected fluid.