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Related Experiment Videos

Necrotizing otitis externa during induction therapy for acute lymphoblastic leukemia.

L J Wolff1

  • 1Department of Pediatrics, Doernbecher Memorial Hospital for Children, Oregon Health Sciences University, Portland 97201.

Pediatrics
|November 1, 1989
PubMed
Summary

Necrotizing otitis externa can occur in children with acute lymphoblastic leukemia and severe neutropenia. Prompt treatment with antibiotics and debridement is crucial for recovery.

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Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Children undergoing acute lymphoblastic leukemia induction therapy often experience severe neutropenia, increasing infection risk.
  • The external ear canal is an important anatomic barrier that can be compromised in immunocompromised patients.

Purpose of the Study:

  • To describe the occurrence and management of necrotizing otitis externa in severely neutropenic children with acute lymphoblastic leukemia.
  • To highlight the microbial associations and clinical outcomes in these cases.

Main Methods:

  • Case series involving three children with acute lymphoblastic leukemia and severe neutropenia who developed necrotizing otitis externa.
  • Clinical data collection including patient history, microbiological cultures, treatment interventions, and outcomes.

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Main Results:

  • Pseudomonas aeruginosa was the most common pathogen isolated, found in all three patients.
  • Staphylococcus aureus and Streptococcus faecalis were also identified in some cases.
  • Two patients recovered with intravenous antibiotics, debridement, and resolution of neutropenia; one required prolonged treatment and surgery.

Conclusions:

  • Necrotizing otitis externa is a potential complication in severely neutropenic children with acute lymphoblastic leukemia.
  • Gram-positive cocci can be associated with this condition, alongside Gram-negative organisms.
  • Maintaining the integrity of the external ear canal is vital for immunocompromised pediatric patients.