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Case Reports
. 2019 Apr 8;12(4):e228026.
doi: 10.1136/bcr-2018-228026.

Rare Case of a 3-year-old With Candida Skull Base Osteomyelitis: Lessons to Be Learnt

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Free PMC article
Case Reports

Rare Case of a 3-year-old With Candida Skull Base Osteomyelitis: Lessons to Be Learnt

Johan Bastianpillai et al. BMJ Case Rep. .
Free PMC article

Abstract

Skull base osteomyelitis (SBO) is a serious and rare condition most commonly seen in elderly diabetic or immunocompromised patients as a complication of otitis externa. We present the case of a previously healthy 3-year-old girl who presented to the paediatric emergency department with vomiting, fever, lethargy, headache and left-sided facial nerve palsy. The initial CT head revealed left-sided otitis media with otomastoiditis and she was managed with intravenous antibiotics and myringotomy with grommet insertion with initial improvement. Two weeks later she re-presented having deteriorated and a dedicated mastoid CT and temporal bone MRI showed SBO. She underwent urgent cortical mastoidectomy where microbiological analysis of the cultures and specimen grew Candida albicans She was subsequently treated with long-term antifungals and antibiotics, and eventually recovered with good effect. The diagnostic dilemma and the empirical treatment of such a rare case are discussed.

Keywords: bone and joint infections; ear, nose and throat/otolaryngology; neuroimaging; otolaryngology/ENT; paediatrics.

Conflict of interest statement

Competing interests: None declared.

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