{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:14:16Z","timestamp":1785838456952,"version":"3.56.0"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,22]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Skull base osteomyelitis (SBO) is a serious and rare condition most commonly seen in elderly diabetic or immunocompromised patients as a complication of otitis externa. We present the case of a previously healthy 3-year-old girl who presented to the paediatric emergency department with vomiting, fever, lethargy, headache and left-sided facial nerve palsy. The initial CT head revealed left-sided otitis media with otomastoiditis and she was managed with intravenous antibiotics and myringotomy with grommet insertion with initial improvement. Two weeks later she re-presented having deteriorated and a dedicated mastoid CT and temporal bone MRI showed SBO. She underwent urgent cortical mastoidectomy where microbiological analysis of the cultures and specimen grew <jats:italic>Candida albicans<\/jats:italic>. She was subsequently treated with long-term antifungals and antibiotics, and eventually recovered with good effect. The diagnostic dilemma and the empirical treatment of such a rare case are discussed.<\/jats:p>","DOI":"10.1136\/bcr-2018-228026","type":"journal-article","created":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T07:15:33Z","timestamp":1554794133000},"page":"e228026","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Rare case of a 3-year-old with <i>Candida<\/i> skull base osteomyelitis: lessons to be learnt"],"prefix":"10.1136","volume":"12","author":[{"given":"Johan","family":"Bastianpillai","sequence":"first","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Northwick Park Hospital, Harrow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidrah","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Lister Hospital, Stevenage, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananth","family":"Vijendren","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Surgery, Lister Hospital, Stevenage, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,8]]},"reference":[{"key":"2025082708310288000_12.4.e228026.1","first-page":"88","article-title":"Osteomyelitis of the frontal bone","volume":"41","author":"Osei-Yeboah","year":"2007","journal-title":"Ghana Med J"},{"key":"2025082708310288000_12.4.e228026.2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/j.1469-0691.2010.03231.x","article-title":"Skull-base osteomyelitis: fungal vs. bacterial infection","volume":"17","author":"Blyth","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"2025082708310288000_12.4.e228026.3","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1115325"},{"key":"2025082708310288000_12.4.e228026.4","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1097\/INF.0000000000000782","article-title":"Nonotogenic skull Base osteomyelitis in children: two Cases and a Review of the literature","volume":"34","author":"Tr\u00fcck","year":"2015","journal-title":"The Pediatric Dis J"},{"key":"2025082708310288000_12.4.e228026.5","doi-asserted-by":"crossref","unstructured":"von Itzstein MS , Abeykoon JP , Summerfield DD , et al . Severe destructive nasopharyngeal granulomatosis with polyangiitis with superimposed skull base Pseudomonas aeruginosa osteomyelitis. 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A case of rransient, isolated cranial nerve VI palsy due to skull Base osteomyelitis. Case Rep Infect Dis 2014;2014. 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