scholarly journals Atypical presentations of malignant otitis externa

2010 ◽  
Vol 124 (11) ◽  
pp. 1205-1208 ◽  
Author(s):  
Z Vourexakis ◽  
M-I Kos ◽  
J-P Guyot
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Skull Base ◽  
Diagnostic Criteria ◽  
Otitis Externa ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Diabetic Patients ◽  
Malignant Otitis Externa ◽  
Life Threatening ◽  
Atypical Presentations

AbstractIntroduction:Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical.Case reports:We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis.Discussion:The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.

Management of malignant (necrotising) otitis externa

2011 ◽  
Vol 125 (12) ◽  
pp. 1212-1217 ◽  
Author(s):  
S Hollis ◽  
K Evans
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Diagnostic Criteria ◽  
Otitis Externa ◽  
Causative Organism ◽  
Current Opinion ◽  
Resistance To Antibiotics ◽  
Common Diagnosis ◽  
Malignant Otitis Externa

AbstractAlthough malignant (necrotising) otitis externa is not a common diagnosis, there have been a number of recently reported cases with pathogens other thanPseudomonas aeruginosaas the causative organism. In addition, there are many published reports of resistance to antibiotics in cases of malignant otitis externa caused byPseudomonas aeruginosa. This review aims to assess the cases reported and to clarify the current opinion on the diagnostic criteria and management of such cases.

scholarly journals New HIV diagnoses in patients with COVID-19: two case reports and a brief literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiu-Cong Zhang ◽  
Xiao-Hui Yu ◽  
Xiao-Han Ding ◽  
Hao-Yu Ma ◽  
Xiao-Qing Cai ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Hiv Infections ◽  
Newly Diagnosed ◽  
Case Presentation ◽  
Multiple Organs ◽  
Life Threatening ◽  
Co Detection ◽  
Atypical Presentations

Abstract Background COVID-19 is novel infectious disease with an evolving understanding of its epidemiology and clinical manifestations. Severe cases developed life-threatening complications, such as respiratory failure, shock, and multiple organs dysfunction. Immunocompromised patients often present atypical presentations of viral infected diseases. Case presentation We report newly diagnosed HIV infections in two patients with COVID-19 in China. In our two cases, both patients with elevated IL-6 received Tocilizumab treatment, but did not present obvious therapeutic effect. Conclusions These cases highlight possible co-detection of known immunocompromised diseases such as HIV. The two cases we reported stressed the risk of misdiagnosis, especially during the pandemic of an infectious disease and the importance of extended testing even if in immune-compromised condition the immune state may be ignored.

scholarly journals Necrotizing Otitis Externa: A Disease Barely Known to Neurosurgeons

2016 ◽  
Vol 38 (03) ◽  
pp. 239-245
Author(s):  
Sérgio Augusto Vieira Cançado ◽  
Lucídio Duarte de Souza ◽  
Rodrigo Moreira Faleiro ◽  
José Maurício Siqueira
Keyword(s):  
Early Diagnosis ◽  
Skull Base ◽  
Otitis Externa ◽  
Clinical Presentation ◽  
Neurological Impairment ◽  
Diabetic Patients ◽  
Necrotizing Otitis Externa ◽  
Clinical Presentations ◽  
Malignant Otitis Externa ◽  
High Index Of Suspicion

AbstractNecrotizing otitis externa (NOE), also known as malignant otitis externa (MOE), is a severe and rare infectious disease of the external auditory canal (EAC). Without treatment, it may progress to skull base involvement. The bacteria Pseudomonas aeruginosa is the most common causative agent (∼ 90% of the cases), and affects immunocompromised subjects, particularly diabetic patients. Severe chronic otalgia, otorrhea, and cranial nerve palsy are the most common clinical presentations. Patients with NOE are frequently referred to neurosurgery because of the neurological impairment and skull base compromise. The definitive diagnosis is frequently elusive, requiring a high index of suspicion. Several laboratorial tests, imaging modalities, and the histologic exclusion of malignancy may be required. An early diagnosis and aggressive treatment reduce morbidity and mortality. We present four NOE cases to illustrate the spectrum of clinical presentation and complementary exams. According to the literature, more effort for early diagnosis and treatment is required, and neurosurgeons play an important role in this task.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Malignant otitis externa in a 21-year-old male patient with Prader–Willi syndrome

2019 ◽  
Vol 7 ◽  
pp. 2050313X1983482
Author(s):  
Marcos Frata Rihl ◽  
Felipe Marchiori Bau ◽  
Igor de Oliveira ◽  
Manoela Astolfi Vivan ◽  
Roseane Cardoso Marchiori
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Male Patient ◽  
Otitis Externa ◽  
Invasive Infection ◽  
Prader Willi Syndrome ◽  
Malignant Otitis Externa ◽  
Life Threatening

Malignant otitis externa is an invasive infection of the external auditory canal and temporal bone with potentially life-threatening complications. Elderly patients with type 2 diabetes mellitus are the population most commonly affected by malignant otitis externa, but any type of immunosuppression predisposes to the disease. Prader–Willi syndrome is a genetic cause of obesity, often associated with insulin resistance and type 2 diabetes mellitus. This report describes a case of a 21-year-old male patient with Prader–Willi syndrome who had malignant otitis externa that progressed to sepsis during hospitalization. To the best of the authors’ knowledge, this is the first description of malignant otitis externa in a young patient with Prader–Willi syndrome.

scholarly journals Advanced Imaging Techniques in Skull Base Osteomyelitis Due to Malignant Otitis Externa

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
A. M. J. L. van Kroonenburgh ◽  
W. L. van der Meer ◽  
R. J. P. Bothof ◽  
M. van Tilburg ◽  
J. van Tongeren ◽  
...  
Keyword(s):  
Skull Base ◽  
Otitis Externa ◽  
Imaging Techniques ◽  
Advanced Imaging ◽  
Skull Base Osteomyelitis ◽  
Malignant Otitis Externa

Malignant Otitis Externa with Skull Base Extension

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
Zgolli Cyrine ◽  
S. Mezri ◽  
H. M'barek ◽  
N. Hlila ◽  
K. Akkari ◽  
...  
Keyword(s):  
Skull Base ◽  
Otitis Externa ◽  
Base Extension ◽  
Malignant Otitis Externa

Resistance of Pseudomonas to ciprofloxacin: implications for the treatment of malignant otitis externa

2006 ◽  
Vol 121 (2) ◽  
pp. 118-123 ◽  
Author(s):  
J M Bernstein ◽  
N J Holland ◽  
G C Porter ◽  
A R Maw
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Otitis Externa ◽  
White Cell Count ◽  
Antibiotic Sensitivity ◽  
Response To Treatment ◽  
Reactive Protein ◽  
Intravenous Antibiotics ◽  
Cranial Nerve Palsies ◽  
Malignant Otitis Externa ◽  
Oral Ciprofloxacin

For fifteen years oral ciprofloxacin has been the standard treatment for malignant otitis externa, a sometimes fatal osteomyelitis of the skull base usually caused by Pseudomonas aeruginosa. Resistance to ciprofloxacin is developing. Over a 16-month period, we saw five cases where malignant otitis externa progressed, with the development of cranial nerve palsies in four cases, despite oral ciprofloxacin. Prolonged intravenous antibiotic therapy became necessary. One case was managed largely as an out-patient, but four patients spent many weeks in hospital. Only two cases had diabetes and this was monitored and controlled. Pseudomonas aeruginosa was isolated in four of the five cases, but antibiotic sensitivity to ciprofloxacin was not determined. In one case a later isolate was tested and found to be ciprofloxacin resistant. Progress was monitored by serial C-reactive protein (CRP) and white cell count. For diagnosis and assessing response to treatment we considered serial magnetic resonance imaging or computed tomography more useful than isotope bone scan. There must be a readiness to use intravenous antibiotics, as a response to ciprofloxacin can no longer be assumed. Bacterial isolates must be tested for sensitivity to antibiotics including ciprofloxacin, and further biopsy and culture are essential if treatment fails.

Malignant otitis externa: case series

2010 ◽  
Vol 124 (8) ◽  
pp. 846-851 ◽  
Author(s):  
T Ali ◽  
K Meade ◽  
S Anari ◽  
M R ElBadawey ◽  
I Zammit-Maempel
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Case Series ◽  
Case Review ◽  
Retrospective Case ◽  
North East ◽  
Malignant Otitis Externa

AbstractBackground:In the light of current concerns regarding ciprofloxacin resistance and the changing face of malignant otitis externa, we reviewed cases of malignant otitis externa treated in our centre, in order both to evaluate the current epidemiology of the condition and to assess the status of drug resistance in our patient population.Method:Retrospective case review of all malignant otitis externa cases managed in a tertiary referral centre in the north-east of England between 2000 and 2009.Results:Forty-one patients were identified, but the required data were available for only 37 cases. Patients' ages ranged from 51 to 101 years (median, 81 years). Diabetes was present in 51 per cent of patients (19/37), facial nerve palsy in 40 per cent (15/37) and multiple cranial nerve palsy in 24 per cent (9/37). Pseudomonas aeruginosa was the most commonly isolated organism (54 per cent), sensitive to ciprofloxacin in all cases.Conclusions:The incidence of cranial nerve palsy in our study was higher than in previous reports. The incidence of diabetes and Pseudomonas aeruginosa in our cohort was much lower than previously reported. The Pseudomonas aeruginosa strains isolated were all sensitive to ciprofloxacin, despite recent reports on emerging resistance.

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