Abstract

Dhanuja Ravichandran, Sinduja R., M. K. Sundar Sri*, Karthickeyan Krishnan, Shanmu Gasundaram Palani

ABSTRACT

Background: Chronic skull osteomyelitis constitutes a rare infection which presents a severe health risk to people who have weakened immune systemse specially to those who have diabetes mellitus. The disease manifests through mild symptoms which result in delayed identification of the condition. Pseudomonas aeruginosa functions as a common pathogen which causes chronic infections because of its ability to withstand treatment. Case Presentation : A 58-year-old male patient who had diabetes mellitus under poor management presented with expanded right parietal scalp swelling which caused him pain and showed intermittent pus discharge. The laboratory tests showed leukocytosis together with increased inflammatory markers and the patient had poor glycemic control which showed an HbA1c level of 9.8 percent. The CT and MRI imaging tests showed osteolytic bone lesions that had destroyed cortical bone and produced marrow edema which doctors used to diagnose chronic osteomyelitis. The microbiological testing of pus showed Pseudomonas aeruginosa as the confirmed organism. The medical team treated the patient with intravenous piperacillin–tazobactam followed by a transition to oral ciprofloxacin and they performed surgical debridement of necrotic bone while maintaining strict blood sugar control through insulin therapy.Conclusion: Chronic skull osteomyelitis requires a high index of suspicion, especially in diabetic patients. Early diagnosis, culture-guided antibiotic therapy, surgical intervention, and optimal glycemic control are critical for successful management and prevention of complications, leading to favorable clinical outcomes.