1364-P: Cinicoradiological and Microbial Spectrum of Skull Base Osteomyelitis and Its relation to Diabetes Mellitus

Abstract

Skull base osteomyelitis (SBO) is a rare life-threatening disease, which is on the increase specifically the incidence of fungal skull base osteomyelitis. Objectives: To describe the demographic, and clinicoradiological profile, and to assess the outcome of skull base osteomyelitis. Methodology: A prospective study from a tertiary care centre, in Kerala from 1st February 2018 to 31st August 2019 with a minimum follow-up of 6 months. All patients diagnosed with skull base osteomyelitis were included. The demographic profile and relevant investigations, radiological correlations and treatment outcomes were analysed. Results and Discussions: 30 patients (23 males and 7 females) were studied. Incidence was found to be high in the age group 51-60 years. The mean (SD) of Age (Years) was 62.02 (14.21), ranging from 1.5-78 years. The most common presentation was a nocturnal earache (86.7%).13.3% of patients presented with headache alone, these cases were diagnosed to be central skull base osteomyelitis and had a significant association with clival erosion. All the patients were having diabetes mellitus except 1.5 yrs old who had congenital cyclic neutropenia. We could see an association between uncontrolled blood glucose and the severity of the disease (P value <0.001). 63.3% of the participants had Cranial Nerve Palsy at the presentation. The culture yielded Pseudomonas followed by staphylococcus aureus, MRSA & Aspergillus. The ESR and CRP levels were reliable for the detection, progression and resolution of disease status in SBO. All patients were treated with third-generation cephalosporins and fluoroquinolones for a minimum of 6 weeks and of which, 12 patients with fungal SBO were given antifungals also. Conclusions: Skull base osteomyelitis is an entity that requires a lifelong commitment. A high index of suspicion, early diagnosis, and prompt and aggressive management are critical for a positive outcome. Uncontrolled diabetes mellitus was the risk factor recognised. Disclosure S.Radhakrishnan: None. D.C: None. V.Dahiya: None. C.R: None.