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Unusual Pathogens

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Cranial Osteomyelitis

Abstract

Very occasionally, bacterial pathogens other than the usual species act as the causative agents for cranial osteomyelitis. Most notable of these are tuberculosis, syphilis, salmonellosis and actinomycosis. Also, fungal infections of the skull bone are rarely seen and are commonly associated in immunosuppression resulting from lengthy steroid use, diabetes mellitus, HIV infection, intravenous drug abuse or occurring in conjunction with severe systemic illness. The most common fungal infection is aspergillosis, cryptococcosis and mucormycosis. Parasitic infestation described in the literature is very rare and the most usual agent is Echinococcus granulosus (hydatid disease). Cranial osteomyelitis related to all these unusual pathogens need to be aggressively treated because of their life-threatening potential and their relative difficulty to eradicate. Additionally, failure to respond to classic therapeutic measures in cranial osteomyelitis is an indication to that an unusual pathogen may be involved. In this chapter we review diagnosis and therapeutic management of the most important unusual pathogens encountered in neurosurgical practice.

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Abbreviations

FNAC:

Fine needle aspiration cytology

HIV:

Human immunodeficiency virus

PCR:

Polymerase chain reaction

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Akhaddar, A. (2016). Unusual Pathogens. In: Cranial Osteomyelitis. Springer, Cham. https://doi.org/10.1007/978-3-319-30268-3_14

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