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Malignant external otitis: now a medical problem.
Diabetes Care
|September 1, 1980
Summary
Malignant external otitis, a severe infection, can spread to the cervical vertebrae. This case highlights the importance of prompt treatment for this dangerous condition, even in elderly diabetic patients.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Neurosurgery
Background:
- Malignant external otitis (MEO) is a severe infection typically affecting the elderly and immunocompromised.
- Pseudomonas aeruginosa is the most common causative pathogen.
- MEO can lead to significant morbidity and mortality, often due to cranial nerve involvement.
Observation:
- A 75-year-old diabetic woman presented with right ear tenderness and neck pain.
- Surgical exploration revealed Pseudomonas aeruginosa in an inflammatory area near the cervical vertebrae.
- The patient exhibited jugular foramen syndrome, involving multiple cranial nerves.
Findings:
- The patient was diagnosed with malignant external otitis with extension to the cervical vertebrae.
- Treatment with parenteral antibiotics resulted in a complete cure.
- This represents the first reported case of MEO with cervical vertebrae invasion.
Implications:
- This case underscores the aggressive nature of MEO and the potential for vertebral spread.
- Early diagnosis and aggressive antibiotic therapy are crucial for managing MEO, especially with cranial nerve involvement.
- The findings emphasize the need for vigilance in immunocompromised patients presenting with otalgia and neck pain.