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Chronic Pseudomonas infections of cochlear implants
John A Germiller1, Hussam K El-Kashlan, Udayan K Shah
1Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA. germiller@email.chop.edu
Summary
Chronic Pseudomonas infections in cochlear implants are rare but challenging. Management often requires device removal and reimplantation for successful outcomes, even with advanced antibiotic therapies.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Biomedical Engineering
Background:
- Cochlear implant infections, particularly chronic Pseudomonas aeruginosa, pose significant management challenges.
- While conservative treatments exist, refractory cases necessitate advanced strategies.
Observation:
- Two pediatric and adult cases presented with delayed, antibiotic-resistant Pseudomonas infections post-cochlear implantation.
- Infections manifested as refractory scalp edema and pain, progressing to device encasement.
Findings:
- Multiresistant Pseudomonas aeruginosa strains were identified in both cases.
- Despite debridement and targeted antibiotics, infections persisted, indicating a distinct clinical entity.
- Partial explantation followed by prolonged medical therapy enabled successful reimplantation.
Implications:
- Chronic Pseudomonas cochlear implant infections may require device explantation and reimplantation.
- Successful reimplantation is feasible, restoring hearing function.
- Further research into distinct clinical entities of implant infections is warranted.