Article in Japanese

Acute otitis media with cerebral vein thrombosis due to bacteremia caused by Streptococcus intermedius

Kiyoka YOSHIMOTO^1）,Makoto FUJIMORI^1）,Azusa CHINO^1）,Shoko HIROSE^1）,Junichi TAKANASHI^1）

Acute otitis media is a common pediatric illness, but sometimes it can cause serious complications such as mastoiditis and intracranial lesions. This is a report on a case of acute otitis media with cerebral vein thrombosis, due to bacteremia caused by Streptococcus intermedius. An 11-year-old girl presenting with fever, earache, neck pain and neck swelling was diagnosed with acute otitis media by an otolaryngologist and prescribed oral antibacterial drugs. The patient was diagnosed subsequently with left mastoiditis and left internal jugular vein thrombosis by contrast-enhanced computed tomography (CT). Magnetic resonance imaging（MRI）of the head and neck showed thrombosis from her sigmoid sinus to internal jugular vein. S. intermedius was detected from a blood culture. She was treated with antibacterial drugs and anticoagulation for bacteremia and thrombosis, respectively.
S. intermedius is the commensal flora of the oral cavity, but may cause serious intracranial complications. This case suggested that acute otitis media with neck pain and neck swelling may be complicated by cerebral venous thrombosis. Therefore, it is important to perform contrast-enhanced CT or MRI.

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1）Department of pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center

Key words	children, cerebral vein thrombosis, Streptococcus intermedius, acute otitis media, neck pain
Received	December 20, 2021
Accepted	August 22, 2022

34 (3)：211─218,2022