{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T19:23:23Z","timestamp":1793733803922,"version":"4.6.1"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"S1","license":[{"start":{"date-parts":[[2012,10,22]],"date-time":"2012-10-22T00:00:00Z","timestamp":1350864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215112002356_sec1\"><jats:title>Introduction:<\/jats:title><jats:p>Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea.<jats:italic>Pseudomonas aeruginosa<\/jats:italic>is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215112002356_sec2\"><jats:title>Methods:<\/jats:title><jats:p>A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215112002356_sec3\"><jats:title>Results:<\/jats:title><jats:p>Twenty patients were identified. A facial palsy was present in 12 patients (60 per cent). Blood cultures were uniformly negative, and culture of ear canal granulations was non-diagnostic in 71 per cent of cases.<jats:italic>Pseudomonas aeruginosa<\/jats:italic>was isolated in only 10 (50 per cent) cases; one strain was resistant to ciprofloxacin but all were sensitive to ceftazidime. Two cases of fungal skull base osteomyelitis were identified. The mortality rate was 15 per cent. The patients\u2019 treatment algorithm is presented.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215112002356_sec4\"><jats:title>Conclusion:<\/jats:title><jats:p>Our treatment algorithm reflects the need for multidisciplinary input, early microbial culture of specimens, appropriate imaging, and prolonged and systemic antimicrobial treatment. Resolution of infection must be confirmed by close follow up and imaging.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215112002356","type":"journal-article","created":{"date-parts":[[2012,10,22]],"date-time":"2012-10-22T12:43:40Z","timestamp":1350909820000},"page":"S8-S12","source":"Crossref","is-referenced-by-count":43,"title":["Skull base osteomyelitis: current microbiology and management"],"prefix":"10.1017","volume":"127","author":[{"given":"P M","family":"Spielmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Neeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2012,10,22]]},"reference":[{"key":"S0022215112002356_ref23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1258\/0022215053222978","article-title":"Radiological and radionuclide investigation of malignant otitis externa","volume":"119","author":"Okapala","year":"2005","journal-title":"J Laryngol Otol"},{"key":"S0022215112002356_ref22","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.196.2.7617867"},{"key":"S0022215112002356_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.10.1002"},{"key":"S0022215112002356_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004617.pub2"},{"key":"S0022215112002356_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1989.01860360072021"},{"key":"S0022215112002356_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/019459989010200315"},{"key":"S0022215112002356_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100101549"},{"key":"S0022215112002356_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110000691"},{"key":"S0022215112002356_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000181185.26410.80"},{"key":"S0022215112002356_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200209000-00017"},{"key":"S0022215112002356_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106002775"},{"key":"S0022215112002356_ref5","doi-asserted-by":"publisher","DOI":"10.1177\/000348947708600401"},{"key":"S0022215112002356_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/19.5.866"},{"key":"S0022215112002356_ref1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196808000-00002"},{"key":"S0022215112002356_ref17","doi-asserted-by":"publisher","DOI":"10.1159\/000239315"},{"key":"S0022215112002356_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(88)90592-X"},{"key":"S0022215112002356_ref2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198609000-00015"},{"key":"S0022215112002356_ref10","unstructured":"2006 Census series: Immigration and Ethnicity in the Auckland region. 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