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Case Report
Online Published: 27 Jun 2026
 


Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case

Emine Çiçek Doğan, Mahsa Akbarpour, Ahmet Nuri Sayın, Hatice Esma Çelik, Ezgi Yılık Kömür, Mustafa Gençeli, Özge Metin Akcan, Demet Aydoğdu.


Abstract
Subdural empyema, mastoiditis, and sinus venous thrombosis are rare infections that may lead to serious and potentially life-threatening complications. A two-year-old male patient with no known underlying disease presented with a two-day history of ear pain, sore throat, and fever. Physical examination revealed no significant pathology other than hyperemia of the left tympanic membrane. Intravenous ceftriaxone was initiated, and the patient was hospitalized because of persistent fever and poor oral intake. However, despite three days of treatment, the fever persisted, and an increase in acute phase reactants was observed. Subsequently, the patient developed hyperemia, swelling, and warmth in the area corresponding to the left mastoid region. Clindamycin was then added to the treatment regimen. Streptococcus pyogenes was isolated from the patient’s blood culture. Brain magnetic resonance imaging revealed a partial thrombus in the left transverse sinus and a 2.5 cm subdural empyema in the lateral aspect of the left cerebellar hemisphere. Antithrombotic therapy was initiated for the patient. Ceftriaxone was administered intravenously for 14 days and clindamycin for 11 days. The total duration of oral and intravenous antibiotic therapy was completed to six weeks, and enoxaparin sodium was given for three months. This case highlights the need for awareness of the rare complications of persistent otitis media in pediatric patients. Conditions such as subdural empyema, mastoiditis, and sinus venous thrombosis can be successfully managed with timely diagnosis and appropriate treatment. Such complications should be considered in cases that do not respond clinically to appropriate antibiotic therapy.

Key words: Acute Mastoiditis, Streptococcus pyogenes, Subdural Empyema, Sinus Venous Thrombosis


 
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How to Cite this Article
Pubmed Style

Doğan EC, Akbarpour M, Sayın AN, Celik HE, Komur EY, Genceli M, Akcan OM, Aydoğdu D. Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudan J Paed. Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193

Web Style

Doğan EC, Akbarpour M, Sayın AN, Celik HE, Komur EY, Genceli M, Akcan OM, Aydoğdu D. Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. https://sudanjp.com//?mno=305838 [Access: June 27, 2026]. doi:10.24911/SJP.106-1767702193

AMA (American Medical Association) Style

Doğan EC, Akbarpour M, Sayın AN, Celik HE, Komur EY, Genceli M, Akcan OM, Aydoğdu D. Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudan J Paed. Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193


Vancouver/ICMJE Style

Doğan EC, Akbarpour M, Sayın AN, Celik HE, Komur EY, Genceli M, Akcan OM, Aydoğdu D. Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudan J Paed, [cited June 27, 2026]; Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193


Harvard Style

Doğan, E. C., Akbarpour, . M., Sayın, . A. N., Celik, . H. E., Komur, . E. Y., Genceli, . M., Akcan, . O. M. & Aydoğdu, . D. (0) Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudan J Paed, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193


Turabian Style

Doğan, Emine Cicek, Mahsa Akbarpour, Ahmet Nuri Sayın, Hatice Esma Celik, Ezgi Yılık Komur, Mustafa Genceli, Ozge Metin Akcan, and Demet Aydoğdu. 0. Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudanese Journal of Paediatrics, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193


Chicago Style

Doğan, Emine Cicek, Mahsa Akbarpour, Ahmet Nuri Sayın, Hatice Esma Celik, Ezgi Yılık Komur, Mustafa Genceli, Ozge Metin Akcan, and Demet Aydoğdu. "Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case." Sudanese Journal of Paediatrics Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193


MLA (The Modern Language Association) Style

Doğan, Emine Cicek, Mahsa Akbarpour, Ahmet Nuri Sayın, Hatice Esma Celik, Ezgi Yılık Komur, Mustafa Genceli, Ozge Metin Akcan, and Demet Aydoğdu. "Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case." Sudanese Journal of Paediatrics Online First: 27 Jun, 2026. Web. 27 Jun 2026 doi:10.24911/SJP.106-1767702193


APA (American Psychological Association) Style

Doğan, E. C., Akbarpour, . M., Sayın, . A. N., Celik, . H. E., Komur, . E. Y., Genceli, . M., Akcan, . O. M. & Aydoğdu, . D. (0) Subdural Empyema, Acute Mastoiditis, and Sinus Venous Thrombosis Associated with Streptococcus pyogenes Bacteremia: A Rare Case. Sudanese Journal of Paediatrics, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1767702193




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