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Skull base osteomyelitis

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https://www.readbyqxmd.com/read/28724596/severe-destructive-nasopharyngeal-granulomatosis-with-polyangiitis-with-superimposed-skull-base-pseudomonas-aeruginosa-osteomyelitis
#1
Mitchell S von Itzstein, Jithma P Abeykoon, Daniel D Summerfield, Jennifer A Whitaker
Skull base osteomyelitis in the setting of granulomatosis with polyangiitis (GPA) is rare and entails significant diagnostic challenges. We present a case of a 65-year-old Caucasian man with a history of rheumatoid arthritis, off immunosuppression for 18 months, who presented with 2 years of chronic headaches, severe fatigue, saddle nose deformity and 20-kilogram unintentional weight loss. Maxillofacial CT revealed an extensive destructive sinonasal and erosive skull base process. Laboratory evaluation showed equivocal elevation of antiproteinase 3 antibodies with negative antineutrophil cytoplasmic antibody panel...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28593115/clival-osteomyelitis-presenting-as-a-skull-base-mass
#2
Matthew Michalowicz, Murugappan Ramanathan
Central skull base osteomyelitis is a rare, but potentially life-threatening disease entity often lacking otologic symptoms or external auditory canal pathology. We present a case of a man in his 70s who had developed cranial nerve deficits with radiographic evidence that was consistent with a tumor due to this uncommon entity. The radiologic findings and our experience are discussed to increase awareness in the otolaryngology community.
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28487802/clinical-challenges-in-the-diagnosis-and-treatment-of-temporal-bone-osteomyelitis
#3
Liubov Kornilenko, Saulius Rocka, Svajunas Balseris, Irina Arechvo
Temporal bone osteomyelitis is a serious life-threatening condition-a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Changing trends of the disease make a differential diagnosis difficult. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. Neoplasm and granulomatous inflammation were excluded by multiple biopsies...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28483146/skull-base-osteomyelitis-secondary-to-malignant-otitis-externa-mimicking-advanced-nasopharyngeal-cancer-mr-imaging-features-at-initial-presentation
#4
J P N Goh, A Karandikar, S C Loke, T Y Tan
PURPOSE: Skull base osteomyelitis (SBOM) is an inflammatory process which often arises from malignant otitis externa (MOE); the diffuse skull base and adjacent soft tissue involvement may be mistaken at initial imaging for advanced nasopharyngeal carcinoma (NPC), especially if there is no prior knowledge of MOE, direct spread from the sphenoid sinus or in atypical presentations of MOE. This study aims to evaluate imaging features on MR that may differentiate SBOM from NPC. MATERIALS AND METHODS: The MR examinations of 26 patients diagnosed with SBOM between January 1996 and January 2013 were retrospectively reviewed...
April 26, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28301961/current-management-of-necrotising-otitis-externa-in-the-uk-survey-of-221-uk-otolaryngologists
#5
Gaurav Chawdhary, Miran Pankhania, Susan Douglas, Ian Bottrill
INTRODUCTION: Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making. This survey aims to report the experience of 221 otolaryngologists in this condition. MATERIALS AND METHODS: Internet survey administered to the membership of the British Association of Otorhinolaryngology - Head and Neck Surgery (ENT UK). RESULTS: Respondents' detailed replies on diagnosis, treatment and follow up are presented...
March 16, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28219414/severe-skull-base-osteomyelitis-caused-by-pseudomonas-aeruginosa-with-successful-outcome-after-prolonged-outpatient-therapy-with-continuous-infusion-of-ceftazidime-and-oral-ciprofloxacin-a-case-report
#6
Cristina Conde-Díaz, Jara Llenas-García, Mónica Parra Grande, Gertrudis Terol Esclapez, Mar Masiá, Félix Gutiérrez
BACKGROUND: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Currently, there is no consensus about the best therapeutic option. Here we describe a case of severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin...
February 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27861948/propionibacterium-skull-base-osteomyelitis-complicated-by-internal-carotid-artery-pseudoaneurysm
#7
Kathryn L Kreicher, Jonathan L Hatch, Shivangi Lohia, Ted A Meyer
The microbiology of skull base osteomyelitis (SBO) is evolving. We present here the first case of SBO caused by Propionibacterium acnes leading to the development of a pseudoaneurysm of the internal carotid artery. Otolaryngologists should recognize this pathogen as a potential cause of invasive temporal bone infection to optimize prompt diagnosis and treatment. Laryngoscope, 2016.
November 15, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27730788/skull-base-osteomyelitis-caused-by-an-elegant-fungus
#8
Sharafine Stephen, Beula Subashini, Regi Thomas, Ajay Philip, Rajan Sundaresan
Malignant otitIs externa (skull base osteomyelitis) is predominantly caused by bacteria while fungal etiology is rare. We report a middle aged diabetic gentleman who succumbed to invasive skull base infection due to Apophysomyces elegans a fungus belonging to Zygomycetes which causes only skin and soft tissue infections. Mortality and invasive infections due to this genus is rarely reported, especially in the ear.
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27701039/central-skull-base-osteomyelitis-involving-cavernous-sinus-and-meninges-of-the-skull-base-successful-treatment-with-antibiotic-and-antifungal-combination-therapy
#9
Tatsuya Ueno, Haruo Nishijima, Rie Haga, Masahiko Tomiyama
No abstract text is available yet for this article.
November 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27671716/analysis-of-prognostic-factors-in-malignant-external-otitis
#10
Sang Kuk Lee, Se A Lee, Sang Woo Seon, Jae Hyun Jung, Jong Dae Lee, Jae Young Choi, Bo Gyung Kim
Objectives: Malignant external otitis (MEO) is a potentially fatal infection of the external auditory canal, temporal bone, and skull base. Despite treatment with modern antibiotics, MEO can lead to skull base osteomyelitis. Until now, there have been few studies on the prognostic factors of MEO. Methods: We performed a retrospective study to identify prognostic factors of MEO, and a meta-analysis of other articles investigating MEO. On the basis of disease progression the 28 patients in our study were divided into 'controlled' and 'uncontrolled' groups, consisting of 12 and 16 patients, respectively...
September 27, 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/27659382/delayed-diagnosis-of-central-skull-base-osteomyelitis-with-abscess-case-report-and-learning-points
#11
G Chawdhary, S Hussain, R Corbridge
Central skull-base osteomyelitis (CSBO) is a rare life-threatening infection, usually resulting from medial spread of necrotising otitis externa. Here, we describe a case with no identifiable source of infection, causing a delay in diagnosis. An 80-year-old man with Crohn's disease treated with mesalazine presented with collapse and tonic-clonic seizure. Computed tomography and magnetic resonance imaging showed a nasopharyngeal mass that was initially thought to be a neoplasm. Awaiting formal biopsy, he represented with collapse and repeat imaging showed features of abscess formation...
January 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27619045/symptomatic-stroke-complicating-central-skull-base-osteomyelitis-following-otitis-media-in-a-2-year-old-boy-case-report-and-review-of-the-literature
#12
REVIEW
Eliz Kilich, Reena Dwivedi, Shelley Segal, Sandeep Jayawant, Manish Sadarangani
We describe the youngest case to date of a 2 year old child who developed central skull base osteomyelitis (SBO) initially presenting with a fever, vomiting and sore throat. An extremely rare complication of mastoiditis following otitis media in children is SBO which can present with non-specific symptoms. This report describes the first case of symptomatic ischaemic stroke secondary to SBO in an immunocompetent child. We review the literature of the management and the potential cerebrovascular complications of central SBO in children secondary to otolaryngological infection...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27597916/a-case-of-skull-base-osteomyelitis-with-multiple-cerebral-infarction
#13
Haruka Miyabe, Atsuhiko Uno, Takahiro Nakajima, Natsue Morizane, Keisuke Enomoto, Masayuki Hirose, Toshinori Hazama, Yukinori Takenaka
Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction...
2016: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/27443284/fungal-skull-base-osteomyelitis-emerging-microbial-identification-techniques
#14
Peter G Volsky, Todd A Hillman
Culture-based pathogen identification in skull base osteomyelitis, particularly for fungi, is often inaccurate. We report the case of patient with fungal skull base osteomyelitis cured by sustained antifungal therapy after 16 months of debilitating illness. Due to medical complications, a strong clinical rationale was needed to justify long-term antifungal therapy. The offending fungus was identified by experimental molecular technology (Ibis T5000 universal biosensor); invasive fungal disease was corroborated by biochemical assays...
January 2017: Laryngoscope
https://www.readbyqxmd.com/read/27340628/central-skull-base-osteomyelitis-diagnostic-dilemmas-and-management-issues
#15
Sujata N Muranjan, Satish V Khadilkar, Sanjay C Wagle, Sunila T Jaggi
The aim of this study is to describe the clinical presentation of central skull base osteomyelitis and to discuss the classical imaging findings and various diagnostic and therapeutic challenges faced in the management of this condition. This is a retrospective analysis of inpatient case records, carried out in a multidisciplinary tertiary care hospital. The study subjects included five elderly diabetic patients presenting to the ENT surgeon or neurologist with headache followed by multiple cranial nerve paralysis with no temporal bone involvement in four patients and a past history of otitis externa in one patient...
June 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27178515/atypical-culture-negative-skull-base-osteomyelitis-masquerading-as-advanced-nasopharyngeal-carcinoma
#16
Anna See, Tiong Yong Tan, Eng Cern Gan
Skull base osteomyelitis typically arises as a complication of otogenic or sinonasal infections in immunocompromised patients. A much rarer entity, atypical skull base osteomyelitis is not associated with an obvious infective source. Atypical and culture-negative skull base osteomyelitis is even rarer and hampers diagnosis, as its clinical presentation is remarkably similar to skull base neoplasms. We report a case of extensive skull base osteomyelitis with orbital apex syndrome and multiple lower cranial nerve palsies which initially masqueraded as possible advanced nasopharyngeal carcinoma...
May 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27134821/scedosporium-apiospermum-as-a-rare-cause-of-central-skull-base-osteomyelitis
#17
Päivi Jalava-Karvinen, Mikko Nyman, Maria Gardberg, Inka Harju, Ulla Hohenthal, Jarmo Oksi
We report a case of Scedosporium apiospermum mold causing ear infection, central skull base osteomyelitis and finally, occlusion of carotid artery in a 48-year-old diabetic man. The exact diagnosis was established and the severity of the disease understood several months after the onset of symptoms. Despite of appropriate antifungal therapy, and repeated surgical and otological procedures, the infection progressed to fatal cerebral infarction.
March 2016: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/27026729/management-strategies-for-skull-base-inverted-papilloma
#18
Jessica W Grayson, Sunny S Khichi, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
OBJECTIVE: Inverted papilloma attached to the ventral skull base presents a surgical dilemma because surgical removal of the bony pedicle is critical to decrease risk of recurrence. The objective of this study is to evaluate the effectiveness of endoscopic management of skull base inverted papilloma. STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary medical center. SUBJECTS: Patients with skull base inverted papilloma...
July 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26977573/-apical-petrositis-osteomyelitis-of-the-base-of-the-skull-bones-and-of-the-first-cervical-vertebra-in-a-5-year-old-children-following-chicken-pox
#19
M R Bogomil'sky, M M Polunin, E I Zelikovich, Yu L Soldatsky, O V Burova
This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid...
2016: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/26929226/granulomatosis-with-polyangiitis-affecting-the-skull-base-and-manifesting-as-spontaneous-skull-base-osteomyelitis
#20
Laura Harrison, Jeremy Mcnally, Rogan Corbridge
A 53-year-old woman presented with right-sided otalgia radiating to the temporal region, angle of the mandible and upper neck. Otoscopy was unremarkable on examination and there were no signs of otitis externa. MRI revealed an infiltrative soft tissue mass to the right lateral aspect of the clivus. Transnasal and CT-guided biopsies were performed, however, these showed either inconclusive or benign tissue. Following multidisciplinary team assessment a diagnosis of spontaneous skull base osteomyelitis was made and treatment with intravenous antibiotics started...
February 29, 2016: BMJ Case Reports
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