TY - JOUR
T1 - Paediatric otogenic sinus venous thrombosis
T2 - the role of Fusobacterium necrophorum
AU - Yosefof, Eyal
AU - Hilly, Ohad
AU - Sokolov, Meirav
AU - Raveh, Eyal
AU - Yacobovich, Joanne
AU - Ulanovski, David
N1 - Publisher Copyright:
© Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale.
PY - 2022/8
Y1 - 2022/8
N2 - Objectives. Sinus venous thrombosis (SVT) is a rare complication of acute otitis media (AOM) with acute mastoiditis (AM), which during recent years has been associated with Fusobacterium necrophorum (Fn) infection. Our objective was to review clinical, micro-biologic, and hematologic features of paediatric otogenic SVT, with a specific focus on the role of Fn. Methods. A retrospective database review in a tertiary paediatric hospital between 2000-2019. Results. Fifty children aged 6-155 months were treated for AM with SVT. Forty-seven (94%) underwent cortical mastoidectomy. Forty-six children received low-molecular-weight heparin (LMWH). Follow-up imaging revealed recanalisation in 92% of cases. No long-term neurologic or haematologic complications were observed. Since 2014, when anaerobic cultures and PCR were routinely used in our institute, Fn was isolated from 15/21 children with SVT. Their time to recanalisation was longer, and the rate of lupus anticoagulant antibodies (LAC) was higher than in the 6 non-Fn patients. Children positive for LAC also had a longer time to recanalisation. Conclusions. Fn is a common pathogen in AM with SVT; its thrombogenic role was demonstrated by a higher prevalence of LAC and a longer time to recanalisation.
AB - Objectives. Sinus venous thrombosis (SVT) is a rare complication of acute otitis media (AOM) with acute mastoiditis (AM), which during recent years has been associated with Fusobacterium necrophorum (Fn) infection. Our objective was to review clinical, micro-biologic, and hematologic features of paediatric otogenic SVT, with a specific focus on the role of Fn. Methods. A retrospective database review in a tertiary paediatric hospital between 2000-2019. Results. Fifty children aged 6-155 months were treated for AM with SVT. Forty-seven (94%) underwent cortical mastoidectomy. Forty-six children received low-molecular-weight heparin (LMWH). Follow-up imaging revealed recanalisation in 92% of cases. No long-term neurologic or haematologic complications were observed. Since 2014, when anaerobic cultures and PCR were routinely used in our institute, Fn was isolated from 15/21 children with SVT. Their time to recanalisation was longer, and the rate of lupus anticoagulant antibodies (LAC) was higher than in the 6 non-Fn patients. Children positive for LAC also had a longer time to recanalisation. Conclusions. Fn is a common pathogen in AM with SVT; its thrombogenic role was demonstrated by a higher prevalence of LAC and a longer time to recanalisation.
KW - Fusobacterium necrophorum
KW - mastoiditis
KW - sinus thrombosis
UR - http://www.scopus.com/inward/record.url?scp=85139802428&partnerID=8YFLogxK
U2 - 10.14639/0392-100X-N1835
DO - 10.14639/0392-100X-N1835
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C2 - 36254655
AN - SCOPUS:85139802428
SN - 0392-100X
VL - 42
SP - 388
EP - 394
JO - Acta Otorhinolaryngologica Italica
JF - Acta Otorhinolaryngologica Italica
IS - 4
ER -