Idiopathic osteomyelitis at the base of the skull.

Osteomyelitis of the skull base is a rare disorder, and even more so when the etiology is noninfectious. Symptoms are noisome and include headache and cranial nerve deficits. Because of the possibility of neoplasia, thorough evaluation, accurate diagnosis, and effective treatment are mandatory. In the case reported herein, a 58-year-old man with a 3-month history of symptoms is presented. Physical examination disclosed cranial nerve involvement. Nasopharyngeal biopsy and culture in combination with MRI and a gallium bone scan established the diagnosis of osteomyelitis at the base of the skull. The patient was effectively treated with antibiotics and had a complete recovery.