Skull Base Osteomyelitis in the Emergency Department: A Case Report

Abstract

Skull base osteomyelitis (SBO) is a rare clinical presentation and usually occurs as a complication of trauma or sinusitis. A 5-year-old child presented to the emergency department with a three-week history of fever associated with drowsiness and left parietal headache, and a week's history of swelling on the left frontoparietal soft tissue. He had suffered a penetrating scalp injury four month ago. On physical examination, there was a tender swelling with purulent stream on the lateral half of his scalp. His vital signs are within normal limits. Plain X-ray of the skull showed a lytic lesion on the left frontoparietal bone. A cranial computed tomography (CT) scan demonstrated a large subgaleal abscess at the left frontoparietal region. SBO possesses a high morbidity and mortality; therefore, prompt diagnosis and appropriate treatment are mandatory to prevent further complications and to reduce morbidity and mortality significantly.

A Rare Case of Skull Base Osteomyelitis Caused By E.Coli and Candida Albicans in A Patient with Gapo Syndrome: A Case Report

“…[9,10]. Many predisposing factors were described for SBO such as trauma, surgical interventions, bacteremia, diseases impairing bone vascularisation and host defences [6]. Craniofacial vasculopathies with dilated calcifications present in our patient as a sign of GAPO syndrome has been considered as a related risk factor for SBO.…”

“…Skull-base osteomyelitis is a very rare disease; with a prevalence of 1.5% in all osteomyelitis [4] occuring secondary to pyogenic and fungal infections [5] Although it is a very rare disease, it has high mortality rate (20-40%) [6]. Therefore, the early diagnosis and appropriate antibiotherapy is crucial in decreasing morbidity and mortality rates [4].…”

Tubercular skull base osteomyelitis – A case report

“…Atypical SBO (also known as central SBO) occurs in the absence of obvious temporal bone or external auditory canal infection involving the sphenoid and occipital bones, especially the clivus part of the latter [4] , [5] , [6] . Most cases of skull osteomyelitis are related to trauma [7] , [8] . In developing countries with limited access to antibiotics, the most common causes of cranial osteomyelitis are paranasal sinuses, direct head injuries, and scalp infections.…”

“…In developing countries with limited access to antibiotics, the most common causes of cranial osteomyelitis are paranasal sinuses, direct head injuries, and scalp infections. In developed nations, postoperative craniotomy infections are the predominant source [7] , [8] . SBO is not common in children and osteomyelitis of skull bones especially atypical involving skull base has never been documented in children.…”

Rare Case of Frontal Bone Hematogenic Osteomyelitis, Complicated by Forehead Part Brain Abscess

“…Удельный вес больных остеомиелитом среди больных гнойными забо леваниями составляет 6 10%. Различные от делы скелета поражаются неодинаково: в 85% -длинные трубчатые кости, в 10% -плоские кости, в 5 % -короткие [6,7]. Остеомиелит костей черепа составляет около 1,5% случаев остеомиелита плоских костей, а гематогенный остеомиелит черепа встречается крайне редко.…”