Challenges in Diagnosis and Management of Skull Base Osteomyelitis: A Case Series

Abstract

Background and Importance: Skull base osteomyelitis (SBO) is a complex disease process often confused with malignancy due to clinical and radiological masquerade. Extensive changes have recently occurred in the clinical course and management of the disease, attributed to improvements in neurosurgical procedures, diagnostic modalities, and the introduction of new antibiotics and management techniques thus reducing the associated morbidities and mortalities. However, SBO continues to pose a major challenge in the form of early diagnosis and management and can be the cause of devastating complications and high fatality associated with the disease. Case Presentation: Here we provide the clinical profile, investigation, management, and outcome of 5 cases of SBO, all of whom were thoroughly examined for the neurological deficit, complete blood count, inflammatory markers, and radiographic imaging. Biopsy and microbiological culture reports were collected and patients were followed up. Conclusion: Early diagnosis and culture-specific antibiotic treatment have been shown to provide good outcomes. Due to its rarity, large case series of SBO are insufficiently found in the literature.

Keywords

• fungal osteomyelitis
• multiple cranial nerve palsy
• skull base osteomyelitis (sbo)