Chronic Suppurative Otitis Media Leading to Cerebral Venous Sinus Thrombosis: A Rare but Serious Complication

Chronic suppurative otitis media (CSOM) is a common otological condition, but its intracranial complications, such as cerebral venous sinus thrombosis (CVST), are rare and potentially fatal. We present a case of 22-year-old male with a long-standing history of CSOM who developed fever, headache, right otalgia, and progressive neurological deterioration. Imaging confirmed CVST secondary to otomastoiditis. The patient was managed with intravenous antibiotics, anticoagulation, and supportive care, leading to significant improvement. This case underscores the importance of early recognition and multidisciplinary management of otogenic CVST to prevent morbidity and mortality. A 22-year-old male farmer from Kho Lam presented with a five-day history of intermittent high fever associated with chills, followed by progressive drowsiness and reduced consciousness over two days. He had a history of right-sided headache and otalgia for two weeks, along with chronic right ear discharge since childhood, which had recently increased and become purulent. On examination at admission, the patient was afebrile, with a Glasgow Coma Scale (GCS) score of 10/15 (E3, V2, M5). Neurological examination revealed unequal pupils (left: 3 mm, right: 5 mm, non-reactive). Neck stiffness and a positive Kernig’s sign were noted. Muscle tone and reflexes were slightly increased in all four limbs, with at least 3/5 muscle power. The plantar response was bilaterally equivocal. ENT examination revealed purulent discharge from the right ear.