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Malignant external otitis with optic neuritis.

C D Holder, M Gurucharri, L J Bartels

    The Laryngoscope
    |September 1, 1986
    PubMed
    Summary
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    Malignant external otitis, a severe Pseudomonas aeruginosa infection, can spread to the skull base, particularly in diabetic patients. This case highlights blindness caused by optic neuritis, emphasizing vascular spread to the orbital apex.

    Area of Science:

    • Infectious Diseases
    • Ophthalmology
    • Otolaryngology

    Background:

    • Malignant external otitis (MEO) is a serious necrotizing infection originating in the external ear canal.
    • Pseudomonas aeruginosa is the typical causative agent, frequently seen in diabetic individuals (90% of cases).
    • The infection can invade the skull base via the temporal bone, leading to cranial nerve palsies.

    Observation:

    • A rare case of MEO presenting with blindness due to optic neuritis is described.
    • The patient experienced vision loss attributed to the infection's progression.

    Findings:

    • Optic neuritis developed as a complication of malignant external otitis.
    • Progressive vascular involvement along the skull base is proposed as the pathogenic mechanism for spread to the orbital apex.

    Related Experiment Videos

  • This pathway explains the extension of infection from the temporal bone to the optic nerve.

    • Implications:

    • This case underscores the potential for severe neurological and ophthalmological complications in malignant external otitis.
    • Understanding the vascular spread mechanism is crucial for early diagnosis and management of MEO.
    • Highlights the importance of aggressive treatment to prevent vision loss and other cranial nerve deficits.