Acute abducens nerve palsy and weight loss due to skull base osteomyelitis.
A 90-year-old man presented to the emergency department with multiple symptoms including double vision, reduced mobility, dysphagia, recent rapid weight loss, ear discharge and deafness. He had diabetes and other chronic medical problems, including otitis media with mastoiditis. This case highlights the difficulty of investigating weight loss in older people, who may not show the usual clinical features of infection, and of distinguishing between infection and malignancy when radiological findings are inconclusive. His eventual diagnosis was osteomyelitis of the skull base with cranial nerve involvement.
Mak
Jenson C S
JC
Department of Geriatric Medicine, Northern Sydney Central Coast Area Health Service, Gosford Hospital, Gosford, NSW, Australia. jenson.mak@gmail.com
Kim
Lawrence H
LH
Ong
Lawrence T C
LT
Bui
Triet M
TM
D020434:Abducens Nerve Diseases / Q000209:etiology*; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000188:drug therapy; D019291:Skull Base; D015431:Weight Loss
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin