Presentation
History of scalp laceration 5 years previously treated with suturing. Subsequently developed swelling, wound rupture, and chronic drainage 2 years later. Failed skin grafts x 2.
Patient Data
Destruction of much of the right parietal bone, portions of the left parietal bone, and the occipital bones, with areas of erosive change. The erosion in the right occipital bone extends to the posterior margin of the right mastoid air cells.
Associated with thinning of the overlying skin with thickening of the dura in the regions of complete loss of bone. Nonspecific thickening near the right vertex. There are no definite drainable fluid collections.
Case Discussion
Severe chronic osteomyelitis involving much of the skull. The two-year delay in symptoms after initial scalp laceration suggests a slowly progressing, indolent infection or newly developed infection.
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