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- Title
Kafa Tabanı Osteomyelitleri ve Uzun Dönem Sonuçları.
- Authors
Başaran, Seniha; Evlice, Oğuz; Benli, Aysun; Şimşek-Yavuz, Serap; Çağatay, Atahan; Öncül, Oral; Özsüt, Halit; Eraksoy, Haluk
- Abstract
Objective: Skull base osteomyelitis (SBO) is a rare, life-threatening infection and frequently followed and treated by otolaryngologists previously. In this study, we analyzed the diagnosis, treatment and long-term outcomes of SBO from the perspective of infectious diseases and clinical microbiology (IDCM). Methods: Hospitalized patients with SBO between 2012-2019 were evaluated retrospectively. Epidemiological, clinical, laboratory data of the patients were recorded. The patients who recovered with and without sequelae were compared. Results: The mean age of 16 SBO cases was 66 years, 75% of them were male and 87.5% had diabetes mellitus (DM). Cranial nerve and vascular/dural involvement were present in 75% and 56.3% of them, respectively. The most common isolated microorganism were P. aeruginosa, staphylococci and Candida spp. 81.2%, 43.7%, and 56% of the patients received anti-pseudomonal antibiotics, additional glycopeptide and additional antifungal drugs, respectively. The sequelae rate was 46.7% in a 24-month follow-up. Hypertension (p=0.041), duration of complaints (p=0.003), bilateral involvement of skull base (p=0.001), vascular thrombosis/inflammation or dural involvement (p=0.007), previous surgical intervention (p=0.041) and elevated ESR at the end of treatment (p=0.014) were defined as risk factors for permanent sequelae. There was no in-hospital mortality. Conclusions: SBO mainly affects older male patients with DM and causes significant sequelae in half of them. In the cases unresponsive to anti-pseudomonal agents, the addition of antifungal therapy empirically may provide a clinical response. Permanent sequelae are more common in cases with delayed diagnosis/treatment, bilateral, vascular or dural involvement, and elevated ESR at the end of treatment. ESR can be used to determine the treatment response and duration. The follow-up and treatment of SBO cases by IDCM with the support of experienced surgeons may contribute to the positive clinical results.
- Subjects
TURKEY; THROMBOSIS complications; ANTIBIOTICS; ANTIFUNGAL agents; HYPERTENSION; OTITIS externa; COMMUNICABLE diseases; CRANIAL nerve diseases; INFLAMMATION; RETROSPECTIVE studies; DIABETES; TREATMENT effectiveness; STAPHYLOCOCCAL diseases; PSEUDOMONAS diseases; BLOOD sedimentation; DESCRIPTIVE statistics; CANDIDIASIS; DISEASE complications
- Publication
Klimik Journal / Klimik Dergisi, 2021, Vol 34, Issue 2, p129
- ISSN
1301-143X
- Publication type
Article
- DOI
10.36519/kd.2021.3897