Polymicrobial skull osteomyelitis: a rare complication of subdural hematoma evacuation.
BACKGROUND
Osteomyelitis of the skull (SO) is a rare condition. The infection may complicate community-acquired sinusitis, otitis, or mastoiditis, in which case, the skull base is affected most commonly. The flora typically seen in these conditions, such as Streptococcus pneumoniae and Haemophilus influenzae, tends also to be responsible for the SO. Osteomyelitis also may follow neurosurgical procedures that breach the skull, in which case, the pathogens frequently are typical cutaneous flora such as Staphylococcus aureus or coagulase-negative staphylococci.


METHODS
A case report of post-neurosurgical SO and a review of the relevant English-language literature.


RESULTS
We report a delayed presentation of SO after craniotomy for the evacuation of a chronic subdural hematoma. Cranial tissue cultures grew Staphylococcus aureus, Corynebacterium spp., and Escherichia coli.


CONCLUSIONS
The isolation of Escherichia coli as an infecting organism in SO has been reported rarely and may reflect a unique pathogenesis.
Calcagno
Scott W
SW
Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.
Graves
Richard M
RM
Baum
Sue E
SE
Teff
Richard J
RJ
D003354:Corynebacterium Infections / Q000150:complications; D003399:Craniotomy / Q000009:adverse effects*; D003428:Cross Infection / Q000382:microbiology*; D004927:Escherichia coli Infections / Q000150:complications; D006408:Hematoma, Subdural / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000382:microbiology*; D012886:Skull / Q000601:surgery; D013203:Staphylococcal Infections / Q000150:complications