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Malignant Otitis External: Our Experience and Literature Review
Antonella M Di Lullo1,2, Camilla Russo3, Piera Piroli1
1Department of Neuroscience, Reproductive and Odontostomatological Sciences, Otorhinolaryngology - Head and Neck Surgery Unit, University of Naples Federico II, Naples, Italy.
The American Journal of Case Reports
|August 19, 2020
Summary
Malignant external otitis (MEO) in diabetic patients requires prompt diagnosis and treatment. This study highlights successful outcomes with intravenous antibiotics, emphasizing the need for vigilant clinical and radiological monitoring.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Diabetology
Background:
- Malignant external otitis (MEO) is a severe invasive infection affecting the ear canal and skull base.
- The condition's epidemiology and management require updated understanding due to evolving clinical presentations.
Observation:
- Three male patients with Type 2 diabetes mellitus presented with chronic otorrhea and pain.
- Pseudomonas aeruginosa was identified in all cases.
- Patients received a 6-week intravenous antibiotic course (ciprofloxacin, piperacillin, tazobactam).
Findings:
- All patients showed rapid symptom improvement.
- Complete recovery was observed at 1-year follow-up.
- Key MEO symptoms include severe otalgia, edema, otorrhea, and potential facial nerve paralysis.
Implications:
- MEO should be suspected in elderly, diabetic, or immunocompromised patients with persistent otalgia.
- Imaging techniques like CT and MRI aid in MEO diagnosis and management.
- Comprehensive assessment including clinical signs, imaging, and inflammatory markers is crucial for evaluating treatment efficacy.
