Conversation: The conversation between human and AI assistant.
[|Human|] Good Afternoon Doctor. I am writing from Bangalore. My Father is 67years old and has been suffering for the past 8 months. 1) The pain initially started in the ear.It was diagnosed as Malignant Otitis Externa. 2) He is diabetic for past 30 years and is on insulin Mixtard 50 for 2 times a day.3) He was on IV antibiotic Monocef for a month and later underwent  mastoidectomy in May as there was no improvement in his pain.4) There was a recurrance of Infection and he was put on Meropenem for 45 days. 1mg 2 times a day.5) Since September there is severe pain in his head and TMJ. His scan shows soft tissue growth.6) Recently he underwent a Biopsy and it shows inflammatory tissue and culture test shows gram positive Cocci.7) The current ENT whom i am consulting says its a tissue growth in the Nasopharnyx area and may have got infected due to MOE but is not a continuation of the same as this in a different area which is not interconnected.8) The doctor also says that this is tissue growing downwards and is not Skull base Osteomyelitis.9) MY father is currently on oral AB Linezolid 600mg for the past 10 days. 10) SInce his condition is not improving and he has lot of pain. when i took a second opinion from another doctor, I was made to understand it is Skull base Osteomyelitis and he says father needs to be put on IV immediately.I am totally confused on what to do and which treatment to consider. Kindly help
[|AI|]  Hi, Welcome to Chat Doctor. I am also suspecting Skull base osteomyelitis because of the following reasons:1. Skull base osteomyelitis is typically seen in a diabetic elderly patient suffering from malignant Otis external.2. Such cases do not respond to strong oral antibiotics. I would suggest to use IV antibiotics and good aural toilet to control the infection. Sugar levels have to be under control for good response. Thanks.