Abstract
Nocardiosis is an infectious disease caused by filamentous, saprophytic bacteria that classically affects the lungs, central nervous system, and skin as an opportunistic infection in immunocompromised patients. Although it can affect any organ system in general, osteomyelitis is not commonly seen and even more rarely involves the skull. We report the uncommon case of a clival osteomyelitis secondary to isolated sphenoid sinusitis caused by Nocardia veterana in an 85-year-old immunocompetent female who presented with right-sided facial pain, abducens nerve palsy, and eventually loss of vision.