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Malignant otitis externa in HIV and AIDS

J D Hern1, J Almeyda, D M Thomas

  • 1Department of Otolarynology, St Mary's Hospital, London, UK.

The Journal of Laryngology and Otology
|August 1, 1996
PubMed
Summary

Malignant otitis externa, a severe Pseudomonas aeruginosa infection, typically affects elderly diabetics but can occur in immunocompromised individuals, including those with HIV/AIDS. This review highlights its occurrence in non-diabetic patients, particularly children.

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Immunology

Background:

  • Malignant otitis externa (MOE) is a severe necrotizing infection of the external ear canal.
  • It often progresses to skull base osteomyelitis, commonly caused by Pseudomonas aeruginosa.
  • MOE typically affects elderly patients with non-insulin-dependent diabetes mellitus.

Observation:

  • Isolated cases of MOE occur in non-diabetic patients, especially immunocompromised children.
  • Cases have been reported in patients with acquired immunodeficiency syndrome (AIDS)-like illness and subsequently in those with human immunodeficiency virus (HIV) infection.
  • This study presents two additional cases of MOE in HIV/AIDS patients and reviews existing literature.

Findings:

  • Pseudomonas aeruginosa is the primary pathogen in malignant otitis externa.

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  • Elderly, non-insulin-dependent diabetics are the most common demographic, but immunocompromised status is a significant risk factor.
  • HIV/AIDS patients represent a vulnerable group for invasive otitis externa.

    • Implications:

    • Increased awareness of MOE in immunocompromised patients, including those with HIV/AIDS, is crucial for early diagnosis and treatment.
    • Understanding risk factors beyond diabetes can improve patient outcomes.
    • Further research into the pathogenesis and management of MOE in specific populations is warranted.