PMC7528195_01
CT orbits with contrast.
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A CT scan with intravenous contrast of the orbits re-demonstrated left-sided mastoiditis and otitis media without osseous erosion however, the left petrous apex showed inflammation suggestive of meningitis (with no clinical evidence of meningeal signs) and cranial fossa osteomyelitis (Fig. 1).
MRI with and without contrast showing abscess.
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A magnetic resonance imaging (MRI) of the head with and without gadolinium was obtained (Fig. 2) which demonstrated left-sided otomastoiditis and petrous apicitis with 1 cm abscess formation in the left petrous apex.
Repeat MRI showing resolution of the abscess.
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A repeat MRI of the head was obtained which showed interval improvement of the leptomeningeal enhancement (Fig. 3).