Djalilian HR, Shamloo B, Thakkar KH, Najme-Rahim M. Treatment of Culture-Negative Skull Base Osteomyelitis.
Otol Neurotol 2006;
27:250-5. [PMID:
16436997 DOI:
10.1097/01.mao.0000181185.26410.80]
[Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
To evaluate the efficacy of a therapeutic regimen in the treatment of patients with culture-negative skull base osteomyelitis.
STUDY DESIGN
Retrospective case review.
SETTING
Tertiary referral hospital.
PATIENTS
Eight patients with diabetes mellitus presented with otalgia and were found to have positive technetium and gallium scans of the temporal bone. These patients, however, all had negative cultures of their external auditory canals. All patients had been treated with ototopic drops and two patients had undergone a 2-week course of oral quinolones.
INTERVENTIONS
All patients were treated with a 6-week course of intravenous ceftazidime or aztreonam for penicillin-allergic patients, oral ciprofloxacin at a higher dose than normal, and topical aminoglycoside steroid drops.
MAIN OUTCOME MEASURES
Resolution of the temporal bone gallium scan abnormality, recurrence rate, and time to discharge from the hospital.
RESULTS
The patients were discharged from the hospital within 4 days from admission. All patients showed resolution of the temporal bone abnormality on the gallium scan at the 6-week time point. The median follow-up period was 6 months, and none of the patients had a recurrence of the infection.
CONCLUSION
The above-described treatment regimen will result in a high cure rate and a short hospitalization period.
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