Clinical and Current Microbiological Profile with Changing Antibiotic Sensitivity in Malignant Otitis Externa

Area of Science:

• Infectious Diseases
• Otolaryngology
• Osteomyelitis

Background:

• Malignant otitis externa (MOE), also known as skull base osteomyelitis, is a rare, aggressive infection of the temporal bone.
• It primarily affects elderly patients with uncontrolled diabetes mellitus.

Purpose of the Study:

• To evaluate the clinical, hematological, and microbiological profiles of MOE patients.
• To assess management strategies and treatment outcomes in a tertiary care setting.
• To review the current literature on MOE.

Main Methods:

• Retrospective analysis of 79 MOE patients diagnosed between January 2015 and June 2021.
• Data collected included clinical findings, imaging, bacteriology, glycemic control, inflammatory markers, and treatment outcomes.
• Literature review was also performed.

Main Results:

• Common findings included otorrhea, otalgia, external auditory canal (EAC) edema, and granulation tissue.
• Facial nerve paralysis occurred in 25.3% of patients; multiple cranial nerve palsies in 6.3%.
• Pseudomonas aeruginosa was the most frequent pathogen, exhibiting 79% ciprofloxacin resistance. Amikacin, Cefaperazone-Sulbactam, and Piperacillin showed sensitivity.

Conclusions:

• Current microbiological profiles necessitate the use of advanced antibiotics for MOE treatment.
• Early diagnosis, stringent diabetes mellitus management, and prolonged culture-sensitive antibiotic therapy are vital for reducing MOE morbidity and mortality.