Skull Base osteomyelitis is a rare clinical entity, even more in the pediatric population, with a high overall mortality. Typical cases appear as a complication of malignant otitis external, compromising the temporal bone. We present a case of a male 11 month old infant that was admitted at the intensive care unit of the Hospital Universitario "José Eleuterio González " located in Monterrey, México, because of a history of 7 days of fever, cough, otorrhea, bipapebral edema with right side conjuntival erythema and septic shock with altered consciousness. After the initial assesment and treatment a non contrasted head CT was made that showed gas density in the skull base, the cavernous sinus and the right transverse sinus topography, right stranding of intraconal fat with a hyperdense a thick right superior ophthalmic vein and hipodense lesions on the brain. Even though the magnetic resonance (MRI) has the higher sensibility and specificity for this image diagnosis, recognizing through a simple head tomography this entity and possible complications is important because of the need of urgent adequate and directed treatment.
Santos-Fernández WJ, Casas-Murillo C*, Ordoñez-Rivas FO and Claudia Yasbek RG