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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1813218
Case Report

Malignant Otitis Externa Complicated by Skull Base Osteomyelitis Presenting as Vernet's Syndrome with Central Venous Thrombosis

Authors

  • Adithyan Athiyaman 

    1   Department of Neurosurgery, Sri Ramakrishna Multi-Specialty Hospital, Coimbatore, Tamil Nadu, India

  • Vikram Muthusubramaniam

    1   Department of Neurosurgery, Sri Ramakrishna Multi-Specialty Hospital, Coimbatore, Tamil Nadu, India

  • Thirumurugan Sivakumaar

    2   Department of Internal Medicine, Sri Ramakrishna Multi-Speciality Hospital, Coimbatore, Tamil Nadu, India

  • Madhumitha Sathishkumar

    3   Department of Pharmacy, Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore, Tamil Nadu, India
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Abstract

Skull base osteomyelitis (SBO) is a rare disease that often has delayed presentation in clinical settings. SBO is often misinterpreted as skull base malignancy, thus posing a challenge in diagnosis. We submit a case that presented with chronic otitis media with multiple cranial nerve palsies. His diagnosis was challenged in view of nonspecific imaging findings and odd presentation, which caused a delay in diagnosis. Methicillin-resistance coagulase-negative Staphylococcus (MRCONS) was isolated from the drained pus. MRCONS usually presents with an indwelling medical device or in severe burn cases. However, isolating and documenting organisms in SBO is needed for rare cases. A final diagnosis of SBO complicated with Vernet's syndrome and sigmoid sinus thrombosis was made. He made good recovery with microbial-specific antibiotics and drainage of abscess with the least improvement on cranial nerve palsies.

Keywords

skull base osteomyelitis - methicillin-resistant coagulase-negative Staphylococci (MRCONS) - central vein thrombosis - chronic suppurative otitis media - Vernet's syndrome


Publication History

Article published online:
20 November 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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