MRSA with progression from otitis media and sphenoid sinusitis to clival osteomyelitis, pachymeningitis and abducens nerve palsy in an immunocompetent 10-year-old patient

Summary A previously healthy 10-year-old patient with headache, otalgia, and hearing loss was diagnosed with pachymeningitis and methicillin-resistant Staphylococcus aureus otitis media and bacteremia. Despite antimicrobial therapy, intracranial extension progressed, including clival osteomyelitis,...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2008-07, Vol.72 (7), p.945-951
Main Authors: Laurens, Matthew B, Becker, Randy M, Johnson, Jennifer K, Wolf, Jeffrey S, Kotloff, Karen L
Format: Article
Language:English
Subjects:
Abducens
Abducens Nerve Diseases - etiology
Abducens Nerve Diseases - microbiology
Child
Cranial Fossa, Posterior
Humans
Male
Meningitis - etiology
Meningitis - microbiology
Methicillin Resistance
Methicillin-resistant Staphylococcus aureus
Nerves
Osteomyelitis
Osteomyelitis - etiology
Osteomyelitis - microbiology
Otitis Media - complications
Otitis Media - microbiology
Otolaryngology
Pachymeningitis
Pediatrics
Sphenoid Sinusitis - etiology
Sphenoid Sinusitis - microbiology
Sphenoidotomy
Staphylococcal Infections - diagnosis
Staphylococcal Infections - drug therapy
Staphylococcus aureus - drug effects
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Summary:Summary A previously healthy 10-year-old patient with headache, otalgia, and hearing loss was diagnosed with pachymeningitis and methicillin-resistant Staphylococcus aureus otitis media and bacteremia. Despite antimicrobial therapy, intracranial extension progressed, including clival osteomyelitis, sphenoid sinusitis, cavernous sinus inflammation and cranial nerve palsies, until the sphenoid sinus was drained. This case exemplifies an aggressive MRSA intracranial infection that advanced despite antibiotic therapy.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2008.02.025