Complications Of Om Flashcards
What is the Hectic Picket-fence type of fever with rigors?
This is due to septicemia, often coinciding with release of emboli into blood stream. Fever is irregular having one or more peaks a day. It is usually accompanied by chills and rigors. Profuse sweating follows fall of temperature. Clinical picture resembles malaria but lacks regularity. Between the bouts of fever, patient is alert with a sense of well-being. Patients receiving antibiotics may not show this picture.
(a) Hectic Picket-fence type of fever with rigors
What is Griesinger’s sign?
This is due to thrombosis of mastoid emissary vein. Oedema appears over the posterior part of mastoid.
(b) Griesinger’s sign
What is Papilloedema?
Its presence depends on obstruction to venous return. It is often seen when right sinus (which is larger than left) is thrombosed or when clot extends to superior sagittal sinus. Fundus may show blurring of disc margins, retinal haemorrhages, or dilated veins. Fundus changes may be absent when collateral circulation is good.
(c) Papilloedema
What is Tobey-Ayer test?
This is to record CSF pressure by manometer and to see the effect of manual compression of one or both jugular veins. Compression of vein on the thrombosed side produces no effect while compression of vein on healthy side produces rapid rise in CSF pressure which will be equal to bilateral compression of jugular veins.
(d) Tobey-Ayer test
What is Tenderness along jugular vein?
This is seen when thrombophlebitis extends along the jugular vein. There may be associated enlargement and inflammation of jugular chain of lymph nodes and torticollis.
(e) Tenderness along jugular vein
What is the treatment for Thrombophlebitis?
Intravenous antibiotic will depend on the condition of the patient. Antibiotics should be continued at least for a week. Mastoidectomy may be required. An infected clot is dangerous and must be drained.
Treatment
What complications can arise from Thrombophlebitis?
Complications include septicaemia, meningitis, cerebellar abscess, thrombosis of jugular vein, cavernous sinus involvement, proptosis, and otitic hydrocephalus.
Complications
What is the purpose of Blood smear?
Blood smear is done to rule out malaria.
(a) Blood smear
What is the purpose of Blood culture?
Blood culture is done to identify the organisms.
(b) Blood culture
What is the purpose of CSF examination?
CSF examination helps to measure pressure and identify the organisms.
(c) CSF examination
What do Imaging studies show?
Imaging studies show sinus thrombosis by area with rim enhancement seen in posterior cranial fossa. It better delineates thrombosis on contrast-enhanced MRI.
(e) Imaging studies
What is Crowe-Beck test?
Pressure on jugular vein of healthy side produces engorgement of retinal veins and supraorbital veins. Engorgement of veins subsides on release of pressure.
(g) Crowe-Beck test
