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What is Hectic picket type of fever with rigor is important feature in and explain in detail?
(B) (Lateral sinus thrombosis) (84- Dhingra 6th)LATERAL SINUS THROMBOSIS* Inflammation of inner wall of lateral venous sinus with formation of an intrasinus thrombosis* Complicatin of - Acute coalescent mastoiditis- Masked mastoiditis- CSOM- Cholesteatoma* Clinical features1. Hectic picket. Fence type of fever with rigor. This is due to septicaemia2. Headache in early stage due to perisinus abscess3. Progressive anaemia and emaciation4. Griesinger's sign- due to thrombosis of mastoid emissary vein.5. Papilloedema6. Tobey-Ayer test - record CSF pressure7. Crowe Beck test = pressure on jugular vein of healthy side produces engorgement of retinal vein(seen in ophthalmoscopy) and supraorbital vein, Engorgement of vein subsides on release of pressure8. Tendemess along jugular veinCT & MRI shows- "Delta sign"TREATMENT(1) Intravenous antibacterial therapy(2) Mastoidectomy and exposure of sinus(3) Ligation of internal jugular vein(4) Anticoagulant therapy.