Am J Otolaryngol Head Neck Surg | Volume 5, Issue 10 | Clinical Image | Open Access

Skull Base Osteomyelitis: Not Just Pseudomonas

Reshma SA* and Noushad M

Dr Noushad’s ENT Hospital and Research Center, India

*Correspondance to: Reshma Saerah Abey, 

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Introduction: Skull base osteomyelitis is a rare life-threatening condition which affects the temporal, sphenoid or occipital bone that can pose a challenge to diagnose because of its nonspecific symptoms, long clinical course, and radiologic findings that mimic those of other entities like malignancies. Prompt diagnosis by early tissue sampling and appropriate treatment is of utmost importance to prevent or limit long term morbidity or complications such as intracranial extension, empyema, or death. This study upholds a higher patient number and hence helps to bring to light, the organisms most likely to cause a skull base osteomyelitis which helps to outline the antibiotic treatment regimen and the probability of it being other invasive species like fungi or tuberculosis and the different course of management that ensues. Objective: To validate the different organisms attributing to skull base osteomyelitis. Materials and Methods: A retrospective study conducted in a tertiary hospital in Cochin, Kerala over a period of 2 year, September 2020 to September 2022 where 50 patients who presented with features suggestive of skull base osteomyelitis, confirmed radiologically, whose pus/tissue was sent for bacterial culture and sensitivity, fungal KOH staining and culture, TB Ziehl Neelsen staining and culture and histology to rule out malignancy were retrieved from data base. Results: Out of 50 patients, 21(42%) patients pus/tissue culture grew strictly Pseudomonas aeruginosa while 10 (20%) showed no growth in any of the culture medium. Sixteen percentage of the culture was positive for fungi, with Candida species being the most prominent followed by invasive Aspergillosis and Mucor. Only 1 case of Tuberculosis was reported in our study. Conclusion: The observation of the varying pattern of the organisms cultured from various patients diagnosed with skull base osteomyelitis will definitely prove fruitful in determining antibiotic protocol.


Osteomyelitis; Aspergillosis; Otogenic


Reshma SA, Noushad M. Skull Base Osteomyelitis: Not Just Pseudomonas. Am J Otolaryngol Head Neck Surg. 2022; 5(10): 1215..

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