A 67-year-old diabetic male patient presented to the Accident & Emergency Department of the Armed Forces Hospital, Muscat, Oman, in 2016 with a headache, low-grade intermittent fever and progressive confusion with decreased sensorium of two weeks' duration. The patient had a past history of malignant otitis externa along with right-sided mastoiditis for which he had undergone a cortical mastoidectomy and debridement seven months previously. He had subsequently developed right-sided facial palsy immediately after the surgery. The patient also disclosed a recent history of admission to a local secondary hospital, at which time a computed tomography (CT) scan of the brain was reportedly unremarkable. An unsuccessful lumbar puncture was attempted and, shortly afterwards, the patient had left the previous hospital against medical advice at the behest of his relatives and sought admission to the Armed Forces Hospital. Unfortunately, no detailed documentation, prior medical reports or imaging scans were available since the patient had been discharged without following the proper referral procedures.