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As the patient\u2019s condition continued to deteriorate, clinical signs of bilateral 10th and 12th cranial nerve paralysis appeared and lead to a focused workup for base of skull pathology. Discussion with the radiologist helped guide the imaging protocol, which leads to the correct diagnosis being made. Treatment was tailored by blood cultures and available images. Temporary immobilisation with a cervical collar and a total of 12 weeks of antibiotics lead to complete remission.<\/jats:p>","DOI":"10.1136\/bcr-2018-227943","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T05:12:29Z","timestamp":1554181949000},"page":"e227943","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Delayed diagnosis of odontoid peg osteomyelitis with bilateral X and XII cranial nerve palsies"],"prefix":"10.1136","volume":"12","author":[{"given":"Faisal Bashir","family":"Chaudhry","sequence":"first","affiliation":[{"name":"Department of Stroke Medicine, John Radcliffe Hospital, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samavia","family":"Raza","sequence":"additional","affiliation":[{"name":"Radiology Department, John Radcliffe Hospital, Oxford, 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