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[Malignant external otitis. Experience with 12 cases]

P Volkow1, M Hernández Palestina, P Vilar-Puig

  • 1Departamento de Infectología, Instituto Nacional de Cancerología, México, D.F.

Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion
|November 1, 1994
PubMed
Summary

Malignant external otitis, a severe infection in diabetic and immunocompromised patients, is effectively treated with combined antimicrobial therapy. Newer treatments, including quinolones, improve outcomes and reduce the need for extensive surgery.

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Medical Microbiology

Background:

  • Malignant external otitis (MEO) is a severe necrotizing infection of the external auditory canal.
  • It primarily affects elderly, diabetic, and immunocompromised individuals.
  • Advances in diagnostics and antimicrobials have impacted MEO management.

Observation:

  • A retrospective review of 12 MEO cases (1982-1991) was conducted.
  • Common symptoms included otalgia, otorrhea, and external auditory canal edema.
  • Pseudomonas aeruginosa was the predominant pathogen identified.

Findings:

  • Computed tomography and radionuclide scanning were utilized for diagnosis and monitoring.
  • Combined antimicrobial therapy (aminoglycoside and anti-pseudomonal beta-lactam) was effective in 11 patients.

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  • Quinolones demonstrated utility, particularly in ambulatory settings.

    • Implications:

    • Combined antimicrobial regimens and quinolones have improved MEO prognosis.
    • These therapeutic strategies can obviate the need for extensive surgical debridement.
    • Optimized treatment may reduce hospital stay and associated morbidity.