Central skull base osteomyelitis: a rare but life-threatening disease
| Autor: | Philippe Eloy, J. F. De Wispelaere, C. Boute, Laura Orioli, Te-Din Huang, B. De Coene, Bénédicte Delaere, Nathalie Ausselet |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Mastoiditis Delayed Diagnosis Malignancy Clivus Ciprofloxacin Medicine Humans Pseudomonas Infections Aged Skull Base business.industry Osteomyelitis General Medicine Emergency department Meropenem medicine.disease Magnetic Resonance Imaging Surgery Anti-Bacterial Agents Skull medicine.anatomical_structure Otitis Earache Thienamycins medicine.symptom Differential diagnosis business |
| Zdroj: | Acta clinica Belgica. 70(4) |
| ISSN: | 1784-3286 |
| Popis: | We present the case of a 70-year-old non-diabetic patient who presented to the emergency department with unrelenting otalgia. A severe otitis externa (OE) and mastoiditis were treated with broad spectrum antibiotics and surgical drainage. No bacteria was isolated from surgical samples. Because the otalgia persisted, a magnetic resonance (MR) was performed and showed an infiltrating process at the skull base. Biopsies failed to prove malignancy or granulomatosis. The patient's neurological state deteriorated. The suspicion of a skull base osteomyelitis (SBO) was raised and proven by CT-guided biopsies that grew Pseudomonas aeruginosa. Meropenem and ciprofloxacin, given for 8 weeks, lead to a fast clinical improvement and a full recovery. SBO is uncommon, often complicating severe OE. Pseudomonas aeruginosa is the main pathogen. Prompt diagnosis and adequate antibiotherapy are required to lower mortality and morbidity. The diagnosis may be delayed because of unawareness and large differential diagnosis including solid neoplasic tumours, malignant hemopathies and granulomatosis. |
| Databáze: | OpenAIRE |
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