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Am J Ophthalmol. 2005 May;139(5):918-20.

Sixth and tenth nerve palsy secondary to pseudomonas infection of the skull base.

Author information

1
Department of Ophthalmology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive PFP, Iowa City, IA 52242, USA. andrew-lee@uiowa.edu

Abstract

PURPOSE:

To describe skull base osteomyelitis, an uncommon complication of chronic otitis media in the post-antibiotic era, as a cause for diplopia.

DESIGN:

Case report.

METHODS:

The records of a patient with skull base osteomyelitis were reviewed.

RESULTS:

A patient presented with a sixth nerve palsy and tenth nerve palsy. Magnetic resonance imaging, bone scan, and gallium scan were helpful in establishing the diagnosis. Cultures grew Pseudomonas. The treatment required long-term intravenous antibiotics.

CONCLUSIONS:

Pseudomonas skull-based osteomyelitis can produce a sixth nerve palsy as a result of the involvement of the clivus. Although uncommon in the post-antibiotic era, early recognition, appropriate diagnostic testing, and aggressive systemic antibiotic treatment might prevent permanent neurologic sequel.

PMID:
15860304
DOI:
10.1016/j.ajo.2004.09.021
[Indexed for MEDLINE]

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