Shinde Vinod, Kothari Aishwarya, Ingale Mayur, Devi Putta Sunanda
Otorhinolaryngology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pune, Pune, IND.
Cureus. 2024 Jul 21;16(7):e65055. doi: 10.7759/cureus.65055. eCollection 2024 Jul.
Clival osteomyelitis is an uncommon skull base infection that mostly affects elderly diabetics and is frequently caused by malignant otitis externa or paranasal sinus infections. It manifests as severe otalgia, fever, auditory fullness, and purulent otorrhea. Clinical history, physical examination, test data, radiographic findings, and pathogen identification all contribute to a diagnosis. Treatment consists of extended intravenous broad-spectrum antibiotics, with severe cases necessitating surgical debridement. We present a case of a 20-year-old girl with bilateral ear discharge, nasal blockage, and purulent rhinorrhea, as well as a dull neck ache increased by extension. An MRI revealed osteomyelitis in the clivus and right atlanto-occipital joint. The clival abscess was drained transnasally using endoscopic techniques. Microbiological tests revealed Streptococcus intermedius. The post-operative recovery was uneventful, with extended antibiotic therapy. Early identification and treatment are critical for preventing serious consequences, as illustrated in this case, where surgical and antibiotic care improves patient outcomes.
斜坡骨髓炎是一种罕见的颅底感染，主要影响老年糖尿病患者，常由恶性外耳道炎或鼻窦感染引起。其表现为严重耳痛、发热、耳闷和脓性耳漏。临床病史、体格检查、检测数据、影像学检查结果和病原体鉴定均有助于诊断。治疗包括长期静脉注射广谱抗生素，严重病例需要手术清创。我们报告一例20岁女孩，有双侧耳漏、鼻塞和脓性鼻漏，以及伸展时加重的颈部钝痛。磁共振成像显示斜坡和右寰枕关节骨髓炎。采用内镜技术经鼻引流斜坡脓肿。微生物检测显示为中间型链球菌。术后恢复顺利，进行了延长疗程的抗生素治疗。早期识别和治疗对于预防严重后果至关重要，如本病例所示，手术和抗生素治疗改善了患者的预后。
