Malignant external otitis: The shifting treatment paradigm.

Area of Science:

• Infectious Diseases
• Otolaryngology
• Microbiology

Background:

• Malignant external otitis (MEO) is a severe infection primarily affecting immunocompromised individuals.
• Rising antimicrobial resistance complicates MEO treatment.
• Understanding current MEO trends is crucial for effective patient management.

Purpose of the Study:

• To investigate potential shifts in the causative microorganisms of MEO.
• To evaluate contemporary outcomes and complications associated with MEO.
• To assess the impact of antimicrobial resistance on MEO treatment efficacy.

Main Methods:

• Retrospective case series analysis.
• Inclusion of 12 recent MEO cases from a tertiary care institution.
• Review of patient data focusing on disease progression, drug resistance, and complications.

Main Results:

• Only 4 out of 12 patients achieved cure.
• MEO resulted in mortality for 4 patients, with at least one death directly attributed to the infection.
• Significant morbidity included cranial nerve palsies (7 patients) and abscess formation (3 patients).

Conclusions:

• Current Malignant external otitis (MEO) cases frequently necessitate multi-drug, long-term parenteral antibiotic regimens.
• Extended hospitalizations are often required for managing complex MEO cases.
• The study highlights the increasing difficulty in treating MEO due to evolving resistance patterns and severe complications.