A rare case report of tubercular osteomyelitis of skull presenting as subdural empyema: post autologous cranioplasty

Anshuman Boarah; Nabajyoti Paul; Zabeena Saeed; Prajna P. Y.

doi:10.18203/2349-2902.isj20250155

Authors

Anshuman Boarah Department of Neurosurgery, Nemcare Hospital, Guwahati, India
Nabajyoti Paul Department of General Surgery, Nemcare Hospital, Guwahati, India
Zabeena Saeed Department of General Surgery, Nemcare Hospital, Guwahati, India
Prajna P. Y. Department of General Surgery, Nemcare Hospital, Guwahati, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250155

Keywords:

Cranioplasty, Tubercular, Osteomyelitis, Subdural empyema

Abstract

Tuberculosis is very rampant disease in LMICs, which has the potential to infect almost every organ/tissue of the body. Subdural empyema (SDE) is the suppurative infection of subdural space confined between duramater and arachnoid mater. In this study we present a case report of 66 year old male presenting with pus discharge from the right side of temporal skin flap for 1 month post autologous cranioplasty and was clinically diagnosed as SDE after radiological investigations, and underwent removal of infected cranioplasty flap. The removal of infected cranioplasty flap sent for histopathology examination revealed necrotizing granulomatous inflammation, suggestive of tubercular osteomyelitis, skull. Post-surgery patient started on ATT. Tubercular osteomyelitis of skull can be radiologically misdiagnosed as SDE, hence warranting the HPE/microbiological confirmation.

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