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Skull base osteomyelitis is 1 of the complications of a middle ear infection seen mainly in immunocompromised individuals. A 3-phase bone scan and clinical, laboratory, and other radiological imaging are used for the diagnosis. However, in previously operated cases, bone scan findings are not reliable. We present a case of a 70-year-old man with persistent ear discharge postsurgery and with 3-phase bone scan negative for active infection. However, a subsequent 18F-FDG-labeled autologous leukocyte PET/CT study was able to diagnose the pre