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[Malignant otitis externa and diabetes: report of 4 cases]

A Lecube Torelló1, C Hernández Pascual, J Lorente Guerrero

  • 1Sección de Endocrinología, Hospital General Universitario Vall d'Hebron, Barcelona.

Revista Clinica Espanola
|February 25, 2000
PubMed

Insights

Malignant otitis externa (MOE), a severe Pseudomonas aeruginosa infection, primarily affects elderly diabetics. Suspect MOE in diabetic patients with persistent otitis, as it can cause cranial nerve issues and bony destruction.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Diabetology

Background:

  • Malignant otitis externa (MOE) is a rare, aggressive infection.
  • Pseudomonas aeruginosa is the primary causative agent.
  • MOE predominantly affects elderly patients with diabetes mellitus.

Observation:

  • Four cases of MOE were diagnosed over seven years.
  • Clinical signs included severe ear pain, discharge, cranial nerve palsies, and bone destruction.
  • Outcomes varied, with one fatality due to bronchoaspiration and two patients experiencing sequelae.

Findings:

  • MOE requires high clinical suspicion in diabetic patients with refractory otitis.
  • Facial palsy in diabetics may indicate MOE, not solely diabetic mononeuropathy.
  • Early diagnosis and intervention are critical for improved outcomes.

Implications:

  • Clinicians should consider MOE in diabetic patients with persistent ear infections.
  • Facial nerve involvement warrants investigation for MOE, especially with coexisting otitis.
  • Prompt recognition and management of MOE can prevent severe complications and mortality.

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