Gradenigo's and Vernet's syndrome in an adult man with Candida mastoiditis.
Maria A ParekhVitor H PachecoPublished in: BMJ case reports (2021)
The authors report a case of fungal otitis media complicated by extension of the infection into adjacent structures causing apical petrositis and subsequently involvement of the jugular foramen in a 71-year-old diabetic man. First described in 1907, Gradenigo's syndrome is a serious but rare clinical triad of acute otitis media, unilateral pain in the distribution of cranial nerve V (trigeminal) and ipsilateral cranial nerve VI (abducens) palsy that commonly presents without all three features and is therefore often missed. In this report, our patient was initially misdiagnosed as having a diabetic cranial neuropathy, and later he developed Vernet's syndrome. Despite aggressive surgical and medical management, he did poorly and died a few weeks later. Clinicians need to be aware of this serious and life-threatening complication of otitis media in high-risk individuals with diabetes or immunocompromised states, to allow early diagnosis and improved clinical outcomes.
Keyphrases
- case report
- type diabetes
- respiratory failure
- cardiovascular disease
- chronic pain
- healthcare
- neuropathic pain
- wound healing
- palliative care
- intensive care unit
- mass spectrometry
- skeletal muscle
- high resolution
- metabolic syndrome
- spinal cord injury
- candida albicans
- drug induced
- pseudomonas aeruginosa
- hepatitis b virus
- preterm birth
- cell wall