[Malignant bilateral external otitis in a 10-year-old girl]

Area of Science:

• Otolaryngology
• Pediatrics
• Endocrinology

Background:

• Malignant external otitis (MEO) is a severe necrotizing infection of the external auditory canal, typically affecting elderly patients with diabetes mellitus.
• The association between MEO and diabetes insipidus (DI) is not well-established, particularly in pediatric cases.

Observation:

• A 10-year-old girl presented with a peculiar case of MEO.
• Initial symptoms included left-sided MEO with concurrent left facial paralysis.
• Six months later, she developed right-sided MEO without facial palsy.
• The patient was also diagnosed with diabetes insipidus of unknown etiology.

Findings:

• This case highlights an unusual presentation of MEO in a pediatric patient with DI.
• The bilateral involvement and the temporal difference in MEO development, along with facial nerve palsy, are noteworthy.
• The co-occurrence of MEO and DI in a young patient warrants further investigation into potential underlying mechanisms.

Implications:

• This case expands the understanding of MEO's clinical spectrum and its potential association with DI in children.
• It underscores the importance of considering MEO in pediatric patients with diabetes, even in the absence of typical risk factors.
• Further research is needed to elucidate the pathophysiology linking MEO and DI in this age group.