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Unilateral proptosis secondary to diffuse condensing osteomyelitis
M R Naidu1, D R Reddy, K V Sastry
1Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, AP, India.
Abstract:
Osteomyelitis of the skull is an uncommon disease in the present days, mainly due to the advent of modern and more effective antibiotics. Hematogenous osteomyelitis is very rare. Osteomyelitis of the skull is usually not associated with sclerosis which is commonly seen in the rest of the skeleton. There are only few occasional case reports of condensing osteomyelitis wherein there was sclerosis of the bone associated with osteomyelitis of the skull and epidural abscess. An unusual case of diffuse condensing osteomyelitis of the skull producing unilateral proptosis is reported. The clinical, radiological features and microbiological aspects are presented. The proptosis was treated by excision of the bone behind the eyeball and thus relieving the proptosis and the impaired vision. The patient was given broad spectrum antibiotics for a period of two months. Further management problems are discussed.
Insights
Skull osteomyelitis is rare, often without bone sclerosis. This case details diffuse condensing osteomyelitis causing proptosis, successfully treated with surgery and antibiotics.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Radiology
Background:
- Skull osteomyelitis is uncommon, particularly hematogenous spread, due to effective antibiotics.
- Typically, skull osteomyelitis lacks the sclerosis seen in other skeletal sites.
- Condensing osteomyelitis with sclerosis and epidural abscess is exceptionally rare.
Observation:
- An unusual case of diffuse condensing osteomyelitis of the skull presented with unilateral proptosis.
- Clinical, radiological, and microbiological features were documented.
- The proptosis was directly linked to the bony changes of the skull infection.
Findings:
- Sclerosis associated with skull osteomyelitis was observed.
- Surgical excision of affected bone behind the eyeball relieved proptosis and visual impairment.
- A two-month course of broad-spectrum antibiotics was administered.
Implications:
- This case highlights a rare presentation of skull osteomyelitis with bone condensation and proptosis.
- Surgical intervention can effectively manage proptosis secondary to skull osteomyelitis.
- Further discussion on management challenges for this rare condition is warranted.
