A Case of Atypical Skull Base Osteomyelitis with Septic Pulmonary Embolism.
10.3346/jkms.2011.26.7.962
- Author:
Soon Jung LEE
1
;
Young Cheol WEON
;
Hee Jeong CHA
;
Sun Young KIM
;
Kwang Won SEO
;
Yangjin JEGAL
;
Jong Joon AHN
;
Seung Won RA
Author Information
1. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. docra@docra.pe.kr
- Publication Type:Case Report
- Keywords:
Mastoiditis;
Skull Base Osteomyelitis;
Thrombophlebitis;
Septic Pulmonary Embolism
- MeSH:
Anti-Bacterial Agents/therapeutic use;
Anticoagulants/therapeutic use;
C-Reactive Protein/analysis;
Cranial Nerve Diseases/complications/diagnosis;
Diagnosis, Differential;
Enterobacter aerogenes/isolation & purification;
Enterobacteriaceae Infections/diagnosis/drug therapy;
Humans;
Lung/pathology/radiography;
Magnetic Resonance Imaging;
Male;
Mastoiditis/complications/diagnosis;
Middle Aged;
Osteomyelitis/complications/*diagnosis/drug therapy;
Pulmonary Embolism/complications/*diagnosis/microbiology;
Sinus Thrombosis, Intracranial/complications/diagnosis;
Skull Base;
Sputum/microbiology;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2011;26(7):962-965
- CountryRepublic of Korea
- Language:English
-
Abstract:
Skull base osteomyelitis (SBO) is difficult to diagnose when a patient presents with multiple cranial nerve palsies but no obvious infectious focus. There is no report about SBO with septic pulmonary embolism. A 51-yr-old man presented to our hospital with headache, hoarseness, dysphagia, frequent choking, fever, cough, and sputum production. He was diagnosed of having masked mastoiditis complicated by SBO with multiple cranial nerve palsies, sigmoid sinus thrombosis, and septic pulmonary embolism. We successfully treated him with antibiotics and anticoagulants alone, with no surgical intervention. His neurologic deficits were completely recovered. Decrease of pulmonary nodules and thrombus in the sinus was evident on the follow-up imaging one month later. In selected cases of intracranial complications of SBO and septic pulmonary embolism, secondary to mastoiditis with early response to antibiotic therapy, conservative treatment may be considered and surgical intervention may be withheld.
