Skull Base Osteomyelitis: A Single-Center Experience

Background Skull base osteomyelitis (SBO) is an uncommon entity and carries a high mortality rate. It can be be odontogenic, sinogenic, or otogenic in origin, in addition to being a complication of skull surgery/trauma. Pseudomonas is one of the most commonly identified pathogen. The goal of the study is to describe the clinical spectrum, microbiologic characteristics, treatment, and its response among different patients with SBO. In addition, we compared the outcomes of bacterial and fungal osteomyelitis. Methodology This is a single-center retrospective analysis of patients with SBO who presented to Shaukat Khanum Memorial Cancer Hospital & Research Centre Lahore, Pakistan between January 1998 and September 2019. A total of 15 patients with SBO were identified. Results SBO was common in males (79.9%) with a high body mass index. Diabetes mellitus was the most common co-morbid condition (46.62%). Bacterial etiology was seen in 46.62% and fungal isolate was detected in 6.66% of the patients; 26.64% were culture-negative and the remaining had a mixed culture. The mean duration of treatment was 17.58 ± 10.85 weeks. Overall, five (33.3%) patients were cured and did not have a recurrence of symptoms at six months, while three (19.98%) had a recurrence of symptoms at six months from the end of the treatment; six (39.96%) patients were lost to follow-up. Conclusions Patients with SBO can present with various conditions, and early identification of the condition and a positive culture growth can guide optimal treatment.