Mycotic Pseudoaneurysm of Internal Carotid Artery Induced by Skull Base Osteomyelitis. Issue 8 (September 2019)

• Record Type: Journal Article
• Authors: Budhiraja, Shilpi; Sagar, Prem; Kumar, Rajeev; Sharma, Suresh C.
• Is Part Of: Otology & neurotology. Volume 40:Issue 8(2019)
• Publication Date: 2019-09
• Subjects: Internal carotid artery -- Mycotic aneurysm -- Pseudoaneurysm -- Skull base osteomyelitis; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000002343
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : 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.