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[Necrotizing otitis externa in a 5-month-old infant]

Mihály Fücsek1, Agnes Kelemen, Péter Jakabos

  • 1Petz Aladár Megyei Oktató Kórház, Gyermek Fül-, Orr-, Gége Részleg, Gyor. drfucsek@t-online.hu

Orvosi Hetilap
|November 7, 2007
PubMed

Insights

A 5-month-old infant recovered from severe bilateral otitis externa and sepsis caused by Pseudomonas aeruginosa. Despite aggressive treatment, reconstructive surgery was needed for auditory canal healing.

Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Surgical Reconstruction

Background:

  • Necrotising otitis externa is a severe infection, particularly in infants.
  • Pseudomonas aeruginosa sepsis can lead to extensive tissue damage.
  • Acute mastoiditis can be a precursor to malignant otitis externa.

Observation:

  • A 5-month-old infant presented with necrotising bilateral otitis externa, right-sided acute mastoiditis, and Pseudomonas aeruginosa sepsis.
  • Despite mastoidectomy, antibiotics, and local treatment, significant necrosis of the external auditory canals occurred.
  • Facial nerve paresis was noted but remained stationary throughout treatment.

Findings:

  • Repeated necrectomies were required to manage the extensive necrosis.
  • Successful bilateral auditory canal reconstructions were performed after inflammation remission.
  • The infant healed with residual symptoms after two months, with no underlying immune deficiency or diabetes identified.

Implications:

  • This case highlights the severity of necrotising otitis externa in infants and the challenges in treatment.
  • Aggressive surgical and medical management, including reconstruction, is crucial for favorable outcomes.
  • Early recognition and intervention are vital to prevent complications like facial nerve palsy.

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