真菌を起炎菌とした頭蓋底骨髄炎例

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  • A Case of Skull Base Osteomyelitis Caused by Fungi
  • シンキン オ キエンキン ト シタ ズガイテイ コツズイエンレイ

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<p>Skull base osteomyelitis is a potentially fatal infection of the external auditory canal.</p><p>This condition was originally described by Chandler in 1968. Diagnosis is made on the basis of clinical, microbiological and radiological findings. The disease originates in the external auditory canal and spreads through the osteocartilaginous junction to involve the soft tissues beneath the temporal bone. Initially, osteomyelitis of the skull bone ensues, followed by involvement of the facial and other cranial nerves.</p><p>The patient was an 87-year old man, who presented with severe headache, severe otorrhea, and otalgia of the right ear. We made the diagnosis of malignant external otitis, a diagnosis of exclusion, based on the imaging findings. The patient received antibiotic, antifungal and hyperbaric oxygen therapy. After treatment at our hospital for 26 days, the patients’ symptoms were improved.</p><p>Headache and otorrhea are commonly encountered symptoms. Otitis with severe headache and a normal serum CRP should raise the index of suspicion for central skull base osteomyelitis or malignancy, and investigation to rule out one or the other should be concurrently.</p>

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