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KMID : 0191120110260070962
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Journal of Korean Medical Science
2011 Volume.26 No. 7 p.962 ~ p.965
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A Case of Atypical Skull Base Osteomyelitis with Septic Pulmonary Embolism
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Lee Soon-Jung
Weon Young-Cheol
Cha Hee-Jeong
Kim Sun-Young
Seo Kwang-Won
Jegal Yang-Jin
Ahn Jong-Joon
Ra Seung-Won
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Abstract
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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.
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KEYWORD
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Mastoiditis, Skull Base Osteomyelitis, Thrombophlebitis, Septic Pulmonary Embolism
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