title: Blastomycotic cranial osteomyelitis.
abstract: This is the second case report of a temporal bone osteomyelitis caused by Blastomyces dermatitidis, which presented as a chronic serous otitis media. The presenting serous otitis media was refractory to conventional medical and surgical management and progressed to a temporal bone osteomyelitis prior to diagnosis. B. dermatitidis is a rare fungal pathogen that causes a systemic pyogranulomatous disease that primarily manifests itself in the skin, bones, pulmonary, and genitourinary systems. If left untreated it is associated with a high rate of mortality. The otologic presentation of this rare disease is emphasized, while the clinical and therapeutic features are reviewed.
authors.affiliation: Department of Otolaryngology, University of Tennessee, Memphis 38103.
authors.forename: R C
authors.initials: RC
authors.lastname: Farr
authors.forename: G
authors.initials: G
authors.lastname: Gardner
authors.forename: J D
authors.initials: JD
authors.lastname: Acker
authors.forename: J M
authors.initials: JM
authors.lastname: Brint
authors.forename: L F
authors.initials: LF
authors.lastname: Haglund
authors.forename: M
authors.initials: M
authors.lastname: Land
authors.forename: J B
authors.initials: JB
authors.lastname: Schweitzer
authors.forename: B C
authors.initials: BC
authors.lastname: West
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001758:Blastomyces / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity; D001759:Blastomycosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D002490:Central Nervous System / Q000187:drug effects; D004432:Ear, Middle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006099:Granuloma / Q000150:complications / Q000473:pathology / Q000601:surgery; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis*; D010033:Otitis Media / Q000175:diagnosis / Q000209:etiology; D013701:Temporal Bone; D014965:X-Rays
chemical_list: D000666:Amphotericin B; D007654:Ketoconazole