Osteomyelitida baze lební mylně léčená jako neuroborrelióza - kazuistika
| Title in English | Skull-base Osteomyelitis Misdiagnosed and Treated as Neuroborreliosis - a case report |
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| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Česká a Slovenská neurologie a neurochirurgie |
| MU Faculty or unit | |
| Citation | |
| Field | Epidemiology, infectious diseases and clinical immunology |
| Keywords | osteomyelitis; skull base; Pseudomonas aeruginosa |
| Description | Skull-base osteomyelitis is a rare disease affecting predominantly patients with diabetes mellitus or with immune dysfunction. The major symptoms include intensive local pain and usually unilateral cranial neuropathy. Pseudomonas aeruginosa or Staphylococcus aureus are the leading causative agents. The diagnosis is confirmed with magnetic resonance imaging (MRI) or single-photon emission tomography (SPECT), eventually combined with computer tomography (SPECT/CT). Broad-spectrum antibiotic treatment with effective pharmacokinetics to bone structures over several weeks is needed. The authors present a case report of a 75-years-old woman with skull-base osteomyelitis who was erroneously treated for neuroborreliosis. The MRI showed an extensive destructive process of the skull-base affecting clivus, left mandible and the first 3 cervical vertebrae. The 14 days lasting treatment with meropenem and subsequent long-term combination treatment with rifampicin/co-trimoxazole led to remission of the disease. |