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Gradenigo’s and Vernet’s syndrome in an adult man with Candida mastoiditis
  1. Maria A Parekh1 and
  2. Vitor H Pacheco1,2
  1. 1Neurology, Baylor College of Medicine, Houston, Texas, USA
  2. 2Neurology, Michael E DeBakey VA Medical Center, Houston, Texas, USA
  1. Correspondence to Dr Maria A Parekh; m.afridi.parekh{at}


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.

  • cranial nerves
  • infection (neurology)

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  • Contributors Both authors contributed equally to the design and conceptualisation of the study. MAP drafted the manuscript for intellectual content and VHP revised the manuscript for intellectual content

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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