Subcutaneous node osteomyelitis of the skull refers to an inflammation caused by subcutaneous node bacillus infection within the skull. It is relatively rare and predominantly occurs in adolescents, often secondary to subcutaneous node infections in other parts of the body. The infection route is almost always hematogenous. Skull subcutaneous node is often accompanied by cervical lymph node subcutaneous node and subcutaneous node in other organs. In the initial stage (first stage), skull subcutaneous node only manifests as a mild pain in the head lump. After abscess formation, it is neither red nor painful, and the abscess may rupture to form a persistent fistula. Treatment mainly involves anti-subcutaneous node therapy and eradication of the infection source, with most cases being curable.

bubble_chart Clinical Manifestations

1. Symptoms include night sweats, low-grade fever, anemia, weight loss, and elevated erythrocyte sedimentation rate, among other signs of subcutaneous nodules. 2. In the initial stage [first stage], there is a localized swelling of the skull with mild pain. After abscess formation, the area is neither red nor painful, and thin pus can be aspirated by puncture. Once ulcerated, the sinus fails to heal for a prolonged period.

bubble_chart Diagnosis

1. Most patients are adolescents with existing subcutaneous node lesions or a history of subcutaneous node disease in other parts of the body. 2. Chronic symptoms such as low-grade fever, anemia, night sweats, weight loss, and accelerated erythrocyte sedimentation rate (ESR) are present. 3. Chronic purulent sinuses are observed in the head. 4. X-ray images reveal round or oval-shaped osteolytic bone destruction with increased bone density at the margins. The skull shows irregular moth-eaten bone destruction, with sequestrum formation in the affected areas.

1. Systemic anti-subcutaneous node and supportive therapy. 2. Surgical treatment can be performed for patients with sequestrum formation if their condition permits. 3. Continue anti-subcutaneous node therapy postoperatively and administer antibiotics.

Subcutaneous node disease, commonly referred to as "pulmonary tuberculosis," is a pestilence disease primarily transmitted through the respiratory tract. Cranial subcutaneous node infection results from hematogenous spread from subcutaneous nodes in other parts of the body. Prevention is the mainstay of treatment, including avoiding contact with pestilence sources and receiving vaccinations after birth to acquire immunity. Additionally, self-isolation should be encouraged, along with promoting hygiene practices such as not spitting indiscriminately. If symptoms such as night sweating, low-grade fever, weight loss, lack of strength, anemia, or chronic purulent sinus discharge from the head occur, this disease should be considered. Patients should not be pessimistic, as they can fully recover by following medical advice, taking anti-subcutaneous node medications, and undergoing surgery when necessary.

bubble_chart Cure Criteria

1. Cure criteria: The source of the disease is eliminated through anti-subcutaneous node treatment and surgery, with local symptoms and signs disappearing. 2. Improvement: The source of the disease is eliminated, and local symptoms and signs improve. 3. No cure: The source of the disease is not eliminated, the incision does not heal, and local symptoms and signs worsen.