Mycotic Pseudoaneurysm of Internal Carotid Artery Induced by Skull Base Osteomyelitis.

Abstract

BACKGROUND\nSkull base osteomyelitis (SBO) is predominantly seen in immunocompromised patients, with diabetes mellitus being the most common underlying comorbidity. Microbial aetiology is commonly bacterial, although fungal SBO is encountered in a small fraction of patients. Treatment consists of prolonged antimicrobial therapy, control of underlying comorbidity, and surgical debridement in selected cases. Involvement of cranial nerves is a common complication and is considered a poor prognostic factor. Pseudoaneurysm of internal carotid artery caused by skull base osteomyelitis is a very rare complication, limited to few case reports only.\n\n\nCASE\nWe report the case of a 55-year-old diabetic patient with bacterial SBO who developed pseudoaneurysm of cervical-petrous part of internal carotid artery during the course of treatment.\n\n\nCONCLUSION\nNew onset symptoms or persistent symptoms in SBO suggest progressive disease and necessitate re-evaluation of the microbial aetiology and antimicrobial treatment. Skull base osteomyelitis induced aneurysm is rare but can be life threatening, if not identified and managed immediately.