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Mycotic Pseudoaneurysm of Internal Carotid Artery Induced by Skull Base Osteomyelitis
Shilpi Budhiraja1, Prem Sagar, Rajeev Kumar
1Department of Otorhinolaryngology and Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
Background:
Skull base osteomyelitis (SBO) is predominantly seen in immunocompromised patients, with diabetes mellitus being the most common underlying comorbidity. Microbial aetiology is commonly bacterial, although fungal SBO is encountered in a small fraction of patients. Treatment consists of prolonged antimicrobial therapy, control of underlying comorbidity, and surgical debridement in selected cases. Involvement of cranial nerves is a common complication and is considered a poor prognostic factor. Pseudoaneurysm of internal carotid artery caused by skull base osteomyelitis is a very rare complication, limited to few case reports only.
Case:
We report the case of a 55-year-old diabetic patient with bacterial SBO who developed pseudoaneurysm of cervical-petrous part of internal carotid artery during the course of treatment.
Conclusion:
New onset symptoms or persistent symptoms in SBO suggest progressive disease and necessitate re-evaluation of the microbial aetiology and antimicrobial treatment. Skull base osteomyelitis induced aneurysm is rare but can be life threatening, if not identified and managed immediately.
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