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Tubercular skull base osteomyelitis - A case report.

Akshaya Sathyamurthy Iyer¹, Priya Venkatesh Patil¹, Deepika Pandey¹

¹Department of General Medicine, Grant Medical College and Sir JJ Group of Hospitals, India.

|December 17, 2021

Summary

Skull base osteomyelitis (SBO) is a rare, fatal infection. This case highlights an unusual presentation of SBO in an immunocompetent child caused by Mycobacterium Tuberculosis.

Keywords:

Immune-competent Mycobacterium tuberculosis Skull base osteomyelitis (SBO)Stroke

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Area of Science:

Infectious Diseases
Osteology
Pediatric Neurology

Background:

Skull base osteomyelitis (SBO) is a severe infection affecting the skull base structures.
Typically observed in immunocompromised individuals, SBO presents a diagnostic challenge.
Early diagnosis and treatment are crucial due to its potentially fatal nature.

Observation:

A 12-year-old immunocompetent female child presented with stroke-like symptoms.
Incidental diagnosis of SBO was made via imaging during emergency room evaluation.
The patient's presentation was atypical for SBO, mimicking neurological emergencies.

Findings:

The causative agent identified was Mycobacterium Tuberculosis, an uncommon pathogen for SBO.
This case represents a rare instance of SBO in a young, immunocompetent patient.
The misleading initial symptoms complicated the diagnostic pathway.

Implications:

Highlights the importance of considering unusual pathogens in SBO, even in immunocompetent patients.
Suggests imaging protocols should be sensitive to SBO in pediatric stroke mimics.
Underscores the need for broader differential diagnoses in pediatric infections presenting with non-specific symptoms.