When vomiting is not caused by a virus

Acute otitis media (AOM) is a very frequent diagnosis in Primary Care, sometimes complicated with suppuration, and less frequently, with mastoiditis.

We present the case of a 6-year-old girl who, after being diagnosed with suppurative AOM and starting antibiotic treatment, began with vomiting, dizziness and headache, as well as poor pain control with the usual analgesia and subsequent photophobia. After several visits, a mastoiditis with thrombosis of the transverse, sigmoid and jugular sinuses was finally diagnosed.

The importance of the case lies in a rapid suspicion of possible complications of otitis media in order to diagnose and treat them early.