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Spontaneous pyogenic spondylodiscitis (SPS) is an uncommon disease. The most common causative organism of SPS is Staphylococcus aureus, followed by Gram-negative bacilli in 4%–30% of the cases. Polymicrobial SPS is very rare, with only a few cases reported in the literature. We report a case of polymicrobial SPS in a 43-year-old male who was recently diagnosed with autoimmune hepatitis with cirrhosis of the liver and presented with a 1-month history of progressive low backache with radiation to both the legs. Initially, he was managed as a case of Pott's spine with antitubercular therapy on the basis of immunocompromised status with positive ascitic fluid Mycobacterium tuberculosis polymerase chain reaction. However, due to lack of clinical and radiological response after 6 weeks, he underwent computed tomography-guided biopsy of the affected region. The culture from the biopsy specimen yielded Klebsiella oxytoca and Proteus vulgaris. He was managed with culture-sensitive antimicrobials. To the best of our knowledge, this is the first case of polymicrobial SPS caused by K. oxytoca, P. vulgaris, and M. tuberculosis.

Background and Importance: Anaplastic Oligodendroglioma (ODG) constitutes 24% of all pediatric ODG. The mean age of presentation of ODG is 12±6 years. They are most common in frontal and temporal lobes; however, rare cases of intraventricular ODGs are reported. Most commonly they arise from the anterior part of lateral ventricles. Third ventricle ODG is extremely rare and only a few cases of lateral and third ventricle anaplastic ODG are reported. ODGs infiltrate locally to meninges and rarely have leptomeningeal spread. Thus, ODG forms a differential diagnosis of pediatric intraventricular tumor. Case Presentation: Here we present a case of a 15-month-old male child with raised intracranial pressure due to obstructive hydrocephalus. The patient was detected to be COVID-19 RT–PCR (Reverse Transcriptase Polymerase Chain Reaction) positive in the preoperative period and underwent emergency Right-sided Ventriculo Peritoneal (VP) shunt. His contrast MRI (Magnetic Resonance Imaging) Brain showed a 50×24×39 mm heterogeneously enhancing mass epicenter at third ventricle and extending to lateral and fourth ventricle with spinal drop metastasis. Preoperative differential diagnosis of Ependymoma was made and definitive surgery was done once the child recovered from COVID-19. However, his biopsy specimen pathology and Immunohistochemistry (IHC) were suggestive of anaplastic oligodendrogliomas and the child responded well to chemotherapy. Conclusion: Intraventricular ODG is an extremely rare pediatric tumor. Patients usually present with obstructive hydrocephalus. Contrast MRI findings are nonspecific and help in detecting leptomeningeal spread to the spine. IHC and chromosomal analysis are important diagnostic and treatment prognostication tools. These tumors have a high recurrence and poor prognosis despite gross total resection.

Background and Importance: Skull base osteomyelitis (SBO) is a complex disease process often confused with malignancy due to clinical and radiological masquerade. Extensive changes have recently occurred in the clinical course and management of the disease, attributed to improvements in neurosurgical procedures, diagnostic modalities, and the introduction of new antibiotics and management techniques thus reducing the associated morbidities and mortalities. However, SBO continues to pose a major challenge in the form of early diagnosis and management and can be the cause of devastating complications and high fatality associated with the disease. Case Presentation: Here we provide the clinical profile, investigation, management, and outcome of 5 cases of SBO, all of whom were thoroughly examined for the neurological deficit, complete blood count, inflammatory markers, and radiographic imaging. Biopsy and microbiological culture reports were collected and patients were followed up. Conclusion: Early diagnosis and culture-specific antibiotic treatment have been shown to provide good outcomes. Due to its rarity, large case series of SBO are insufficiently found in the literature.

Ectopic recurrence of craniopharyngiomas after surgical resection of primary lesion is extremely rare. In this article, the authors describe a case of a 12-year-old girl with ectopic recurrence of craniopharyngioma in an extra-axial location in the right frontal region, after an attempt to completely resect the lesion originally located in the sellar region. The patient was investigated radiologically, hormonally, and histopathologic confirmation was sought. During surgery, it is important to take extra care in removing the primary lesion in toto. In case of cystic tumors, it is very important to aspirate cystic fluid completely, before resecting the capsule to avoid rupture or spillage. Long-term clinical and radiologic follow-up is suggested as ectopic recurrence may occur at a very late stage.