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Malignant external otitis in children.

J Rubin¹, V L Yu, S E Stool

¹Department of Otolaryngology, University of Pittsburgh, Pennsylvania.

The Journal of Pediatrics

|December 1, 1988

Summary

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Malignant external otitis, a Pseudomonas aeruginosa infection, affects immunocompromised children, causing severe ear pain and potential bone destruction. Early diagnosis and anti-Pseudomonas treatment are crucial to prevent complications like facial nerve paralysis.

Area of Science:

Pediatric Infectious Diseases
Otolaryngology
Microbiology

Background:

Malignant external otitis (MEO) predominantly affects immunocompromised pediatric patients.
It is characterized by Pseudomonas aeruginosa infection, severe otalgia, otorrhea, elevated erythrocyte sedimentation rate, and bone destruction on CT scans.

Purpose of the Study:

To review the clinical presentation and management of MEO in children.
To highlight the emerging nature of this infection in the pediatric population and emphasize the need for prompt diagnosis and treatment.

Main Methods:

Literature review of MEO cases in children.
Analysis of clinical features, diagnostic criteria, and treatment outcomes.

Main Results:

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Pediatric MEO cases show higher incidence of seventh nerve paralysis and middle ear involvement compared to adults.
A significant increase in reported cases since 1980 suggests an emerging trend.
Prompt diagnosis and early anti-Pseudomonas therapy are associated with reduced morbidity.

Conclusions:

Malignant external otitis is an increasingly recognized, treatable infection in children.
Pediatricians must be aware of the distinct clinical manifestations and the urgency of initiating appropriate therapy.
Early intervention can significantly alleviate patient morbidity.