Roohollahi Faramarz, Iranmehr Arad, Fatahi Andabili Ehsan
Neurological Surgery Department, Shariati Hospital Complex Tehran University of Medical Sciences Tehran Iran.
Neurological Surgery Department, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran Iran.
Clin Case Rep. 2022 Dec 26;10(12):e6744. doi: 10.1002/ccr3.6744. eCollection 2022 Dec.
Skull base osteomyelitis is a rare but dangerous consequence of untreated malignant otitis externa. Pseudomonas aeruginosa is responsible for most cases with typical presentation. Here, we discuss a diabetic 54-year-old female presented with malignant otitis externa and bilateral facial paresis followed by cervical spondylitis and C1-C2 instability. Skull base osteomyelitis confirmed by clinical presentation, imaging, and laboratory data. Fortunately, she responded well to antibacterial and antifungal therapy. Due to limited data, there is no confirmed standard of treatment for cervical instability secondary to SBO. It seems antibiotic therapy is the mainstay of treatment. In case of poor response to antibiotic therapy, surgical intervention is inevitable. This article introduces the first case of SBO-related AAI successfully managed with conservative treatment.
颅底骨髓炎是未治疗的恶性外耳道炎罕见但危险的后果。铜绿假单胞菌是大多数典型病例的致病菌。在此，我们讨论一名54岁的糖尿病女性患者，其表现为恶性外耳道炎和双侧面瘫，随后出现颈椎病和C1-C2不稳。通过临床表现、影像学和实验室数据确诊为颅底骨髓炎。幸运的是，她对抗菌和抗真菌治疗反应良好。由于数据有限，对于继发于颅底骨髓炎的颈椎不稳尚无确诊的治疗标准。抗生素治疗似乎是主要的治疗方法。如果对抗生素治疗反应不佳，手术干预不可避免。本文介绍了首例通过保守治疗成功处理的与颅底骨髓炎相关的寰枢关节不稳病例。
