Management of malignant (necrotising) otitis externa

S Hollis1, K Evans

  • 1ENT Department, Gloucestershire Royal Hospital, Gloucester, UK. sophie_hollis@hotmail.com

Insights

Malignant otitis externa, often caused by Pseudomonas aeruginosa, is increasingly reported with other pathogens and antibiotic resistance. This review examines recent cases to update diagnostic criteria and management strategies for this rare infection.

Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Microbiology

Background:

  • Malignant otitis externa (MOE) is a severe infection of the external ear canal.
  • Recent reports indicate pathogens beyond Pseudomonas aeruginosa causing MOE.
  • Antibiotic resistance in Pseudomonas aeruginosa-related MOE is a growing concern.

Purpose of the Study:

  • To review recent cases of malignant otitis externa.
  • To identify non-Pseudomonas aeruginosa causative organisms.
  • To clarify current diagnostic criteria and management approaches.

Main Methods:

  • Literature review of reported malignant otitis externa cases.
  • Analysis of causative pathogens and their antibiotic susceptibility.
  • Assessment of diagnostic methods and treatment outcomes.

Main Results:

  • Identification of diverse bacterial pathogens in MOE cases.
  • Documentation of increasing antibiotic resistance patterns.
  • Variability in diagnostic approaches and treatment efficacy.

Conclusions:

  • Malignant otitis externa necessitates consideration of a broader range of pathogens.
  • Antibiotic stewardship is crucial due to emerging resistance.
  • Standardized diagnostic and management protocols are needed for optimal patient outcomes.

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