title: Community-acquired methicillin-resistant Staphylococcus aureus skull base osteomyelitis with occipital condylar cerebrospinal fluid leak in an immunocompetent patient.
abstract: Community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is emerging as an important pathogen in paranasal sinus disease. However, sinonasal CA-MRSA has not been reported as a source of central skull base osteomyelitis. We report an unusual case of a previously healthy and immunocompetent adult who developed meningitis, central skull base osteomyelitis, and occipital condylar cerebrospinal fluid rhinorrhea from CA-MRSA sphenoid sinusitis requiring endoscopic surgical repair. This case clearly demonstrates the expanding spectrum of severe infections caused by CA-MRSA, which requires prompt diagnosis, a high level of suspicion, and appropriate medical and/or surgical management.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Senja
authors.initials: S
authors.lastname: Tomovic
authors.forename: Mark E
authors.initials: ME
authors.lastname: Friedel
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology*; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D019291:Skull Base; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D014057:Tomography, X-Ray Computed