A Case of Atypical Skull Base Osteomyelitis Secondary to Otitis Media Due to Delayed Diagnosis

Area of Science:

• Otolaryngology
• Infectious Diseases
• Radiology

Background:

• Skull base osteomyelitis (SB0) is a rare complication of otitis media, particularly in the antibiotic era.
• The COVID-19 pandemic has been associated with delayed medical diagnosis and treatment, potentially increasing risks for secondary infections.
• Otitis media, though common, can lead to severe complications in immunocompromised or elderly patients.

Observation:

• An 84-year-old male with diabetes presented with atypical skull base osteomyelitis secondary to otitis media.
• The patient's condition was exacerbated by delayed diagnosis and incomplete treatment during the COVID-19 pandemic.
• The presentation of SB0 was atypical, posing significant diagnostic challenges.

Findings:

• This case underscores the potential for otitis media to cause life-threatening skull base osteomyelitis even in the modern medical era.
• Delayed diagnosis and treatment were identified as key factors contributing to the development of SB0 in this patient.
• Atypical presentations of SB0 necessitate a high index of suspicion and thorough diagnostic evaluation.

Implications:

• Healthcare providers must remain vigilant for rare but severe complications of common infections like otitis media, especially in vulnerable populations.
• Aggressive and timely management of skull base osteomyelitis is essential for improving patient outcomes.
• This case highlights the importance of prompt medical attention, even for seemingly minor infections, particularly during public health crises like the COVID-19 pandemic.