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On examination, she had ptosis of the left eye with chemosis, dilated pupil with only perception of light and restricted ocular mobility. Oral examination revealed trismus and bulge in the left peritonsillar region. Left ear examination revealed a large central perforation with mucopurulent discharge. CT of the neck with contrast demonstrated a collection in the left peritonsillar space with left internal carotid artery thrombosis. MRI of the brain with gadolinium revealed left cavernous sinus thrombosis with acute infarcts in the left frontal lobe. An emergency incision and drainage of the left peritonsillar abscess was performed. Culture grew broad aseptate fungal hyphae. Despite starting on antifungal therapy, she succumbed to her illness.<\/jats:p>","DOI":"10.1136\/bcr-2020-236723","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T18:32:28Z","timestamp":1610476348000},"page":"e236723","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Skull base osteomyelitis with secondary cavernous sinus thrombosis: a rare presentation of an animate foreign body in the ear"],"prefix":"10.1136","volume":"14","author":[{"given":"Anu","family":"Alex","sequence":"first","affiliation":[{"name":"Department of ENT\u2014Otology, Neurotology & Cochlear Implant Unit, Christian Medical College and Hospital Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of ENT\u2014Otology, Neurotology & Cochlear Implant Unit, Christian Medical College and Hospital Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony Abraham","family":"Paulose","sequence":"additional","affiliation":[{"name":"Department of ENT\u2014Otology, Neurotology & Cochlear Implant Unit, Christian Medical College and Hospital Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manju Deena","family":"Mammen","sequence":"additional","affiliation":[{"name":"Department of ENT\u2014Otology, Neurotology & Cochlear Implant Unit, Christian Medical College and Hospital Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjali","family":"Lepcha","sequence":"additional","affiliation":[{"name":"Department of ENT\u2014Otology, Neurotology & Cochlear Implant Unit, Christian Medical College and Hospital Vellore, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2025082722270569000_14.1.e236723.1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/myc.12897","article-title":"Mucormycosis-A clinicoepidemiological review of cases over 10 years","volume":"62","author":"Manesh","year":"2019","journal-title":"Mycoses"},{"key":"2025082722270569000_14.1.e236723.2","doi-asserted-by":"crossref","first-page":"834","DOI":"10.4103\/jfmpc.jfmpc_62_19","article-title":"Clinical characteristics and complications of skull base osteomyelitis: a 12-year study in a teaching hospital in South India","volume":"8","author":"Das","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"2025082722270569000_14.1.e236723.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-012-0272-6"},{"key":"2025082722270569000_14.1.e236723.4","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-011-0156-3"},{"key":"2025082722270569000_14.1.e236723.5","first-page":"1078","article-title":"Diversity and abundance of scarabaeid beetles in South India","volume":"8","author":"Srinivasa Murthy","year":"2020","journal-title":"Journal of Entomology and Zoology Studies"},{"key":"2025082722270569000_14.1.e236723.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2006.06.018"},{"key":"2025082722270569000_14.1.e236723.7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.emc.2012.09.010","article-title":"Critical ENT skills and procedures in the emergency department","volume":"31","author":"Falcon-Chevere","year":"2013","journal-title":"Emerg Med Clin North Am"},{"key":"2025082722270569000_14.1.e236723.8","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1097\/00005537-200311000-00010","article-title":"External auditory canal foreign body removal: management practices and outcomes","volume":"113","author":"Thompson","year":"2010","journal-title":"Laryngoscope"},{"key":"2025082722270569000_14.1.e236723.9","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.126724"},{"key":"2025082722270569000_14.1.e236723.10","doi-asserted-by":"publisher","DOI":"10.1136\/emj.17.2.91"},{"key":"2025082722270569000_14.1.e236723.11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0385-8146(99)00035-8","article-title":"Acute otalgia: a case report of mature termite in the middle ear","volume":"27","author":"Supiyaphun","year":"2000","journal-title":"Auris Nasus Larynx"},{"key":"2025082722270569000_14.1.e236723.12","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1017\/S0022215115000961","article-title":"Hazardous complications of animate foreign bodies in otology practice","volume":"129","author":"Sikka","year":"2015","journal-title":"J Laryngol Otol"},{"key":"2025082722270569000_14.1.e236723.13","doi-asserted-by":"crossref","unstructured":"Kancharu FK , Viswam V , Sreeram P , et al . 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