scholarly journals Malignant Otitis Externa Outcomes: A Study of the University HealthSystem Consortium Database

2018 ◽  
Vol 127 (8) ◽  
pp. 514-520 ◽  
Author(s):  
Jonathan L. Hatch ◽  
Michael J. Bauschard ◽  
Shaun A. Nguyen ◽  
Paul R. Lambert ◽  
Ted A. Meyer ◽  
...  
Keyword(s):  
Otitis Externa ◽  
The Elderly ◽  
Elderly Male ◽  
Patient Demographics ◽  
Nerve Involvement ◽  
Malignant Otitis Externa ◽  
Patients At Risk ◽  
The Mean ◽  
The University ◽  
Overall Mortality

Objective: To characterize factors that affect outcomes for patients with malignant otitis externa (MOE). Methods: Retrospective review of inpatients with MOE was performed. Patient demographics, comorbid conditions, complications, procedures, and mortalities were analyzed. Results: A total of 786 patients with MOE were identified. The mean hospitalization length of stay (LOS) was 18.6 days (SD = 19.7). The overall mortality rate was 2.5% (n = 20), and complication rate was 4.3% (n = 34). Increasing age significantly and positively correlated with the incidence of MOE (r = 0.979, P < .0001). Factors that were associated with an increased rate of mortality were sepsis (odds ratio [OR] = 18.5; ES = 0.94; 95% CI, 0.47-1.42), congestive heart failure (OR = 3.1; ES = 0.42; 95% CI, 0.02-0.82), weight loss (OR = 10.2; ES = 1.23; 95% CI, 0.61-1.85), and coagulopathy (OR = 8.8; ES = 1.84; 95% CI, 0.91-2.77). Surgical intervention was performed in 19.2% (n = 151) of patients. Facial nerve involvement was present in 15.5% (n = 122) of patients and was associated with a significantly longer LOS of 12.9 days (SD = 19.6; ES = 0.21; 95% CI, 0.03-0.41). Conclusions: This large multi-institutional database study of MOE demonstrates that several patient factors impact the LOS and mortality. Patients at risk for unfavorable outcomes include the elderly, male gender, comorbidities, or cranial nerve involvement.

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&lt; 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&lt; 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

Necrotising (malignant) otitis externa in the UK: a growing problem. Review of five cases and analysis of national Hospital Episode Statistics trends

2015 ◽  
Vol 129 (6) ◽  
pp. 600-603 ◽  
Author(s):  
G Chawdhary ◽  
N Liow ◽  
J Democratis ◽  
O Whiteside
Keyword(s):  
Otitis Externa ◽  
Severe Infection ◽  
Fold Increase ◽  
Antibiotic Resistant ◽  
Catchment Population ◽  
Malignant Otitis Externa ◽  
The Mean ◽  
The Uk ◽  
High Index Of Suspicion ◽  
Park Hospital

AbstractBackground:Necrotising (malignant) otitis externa is a severe infection causing temporal bone osteomyelitis. Although rare, our experience (reported herein) shows local doubling of cases in 2013. Hospital Episodes Statistics data for England over 14 years also indicate increased incidence nationally. Specific learning points in management are also discussed.Methods:A retrospective review was conducted of patients admitted in 2013 to Wexham Park Hospital, Slough, UK (catchment population, 450 000). In addition, the UK Government Hospital Episodes Statistics data were interrogated.Results:There were five cases of necrotising (malignant) otitis externa in 2013, representing a local doubling on previous years. The mean age of patients was 82 years. All cultures grew Pseudomonas aeruginosa; no isolates were antibiotic resistant. All patients responded to systemic anti-pseudomonals on clinical, biochemical and radiological parameters. Hospital Episodes Statistics data showed a six-fold increase in the number of cases from 1999 (n = 67) to 2013 (n = 421).Conclusion:Our experience suggests increasing necrotising (malignant) otitis externa incidence, and retrospective analysis of Hospital Episodes Statistics data supports this observation. Necrotising (malignant) otitis externa poses challenges in management, as exemplified in our cases, requiring a high index of suspicion and early aggressive treatment to achieve cure.

Malignant otitis externa, an increasing burden in the twenty-first century: review of cases in a UK teaching hospital, with a proposed algorithm for diagnosis and management

2019 ◽  
Vol 133 (05) ◽  
pp. 356-362
Author(s):  
K H Hutson ◽  
G J Watson
Keyword(s):  
Teaching Hospital ◽  
Otitis Externa ◽  
Best Practice ◽  
Case Series ◽  
Prognostic Indicators ◽  
Haemoglobin A1c ◽  
Ageing Population ◽  
Elderly Male ◽  
Treatment Pathways ◽  
Malignant Otitis Externa

AbstractBackgroundMalignant otitis externa is a potentially fatal infection of the skull base. With an ageing population and increasing prevalence of diabetes, the incidence of malignant otitis externa in the British population is rising. To date, there remain no accepted diagnostic criteria, few prognostic indicators and no consensus treatment pathways.MethodA prospective case series was conducted at a tertiary referral teaching hospital.ResultsA cohort of susceptible individuals predominates (elderly, male, with immunosuppression and diabetes), with 25 per cent reporting a preceding incident. Otorrhoea, otalgia and canal granulation were the commonest presenting features, alongside positive pseudomonas cultures. No clear markers for predicating disease severity were isolated; however, a high initial haemoglobin A1c level demonstrated a significant moderately positive correlation with length of treatment.ConclusionA treatment pathway designed to provide a standardised approach to investigation and treatment is proposed, which aims to increase earlier diagnosis, streamline care and facilitate the development of best practice.

A 12-year review of cases of adult tetanus managed at the University College Hospital, Ibadan, Nigeria

2007 ◽  
Vol 37 (3) ◽  
pp. 170-173 ◽  
Author(s):  
E O Sanya ◽  
S S Taiwo ◽  
J K Olarinoye ◽  
A Aje ◽  
O O M Daramola ◽  
...  
Keyword(s):  
Post Injury ◽  
Tertiary Institution ◽  
Southwestern Nigeria ◽  
College Hospital ◽  
Factors Associated ◽  
Bladder Obstruction ◽  
The Mean ◽  
The University ◽  
Overall Mortality ◽  
Ibadan Nigeria

In this review, hospital case records of 202 adult tetanus managed between January 1990 and December 2001 in a tertiary institution in Southwestern Nigeria were reviewed. The mean age of the patients was 36.1±17.8 years with male:female ratio of 2.2:1 and an overall mortality rate of 64%. Patients with unfavourable outcomes spent 4.5±0.41 days compared with 16.6±1.2 days by those who survived. Factors associated with poor prognosis are age >60 years ( P=0.029), incubation period <7 days ( P=0.007), period of onset <48 h ( P=0.0001), tachycardia with pulse rate >120/min ( P=0.001) and spasm ( P=0.002). Gender ( P=0.11), post-injury vaccination ( P=0.48) and types of antibiotics administered ( P=0.49) were not significantly associated with increased mortality. The three most common complications were aspiration pneumonitis, sepsis and urinary bladder obstruction while complications with highest mortality (100%) were sepsis and cardiac arrest.

Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

2013 ◽  
Vol 19 (1) ◽  
pp. 33 ◽  
Author(s):  
Somnath Saha ◽  
Kanishka Chowdhury ◽  
Sudipta Pal ◽  
VedulaPadmini Saha
Keyword(s):  
Cranial Nerve ◽  
Otitis Externa ◽  
Cranial Nerve Involvement ◽  
Unique Case ◽  
Nerve Involvement ◽  
Malignant Otitis Externa

Malignant Otitis Externa Resistant to Ciprofloxacin: Implications for Treatment

Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
T. Mandrali ◽  
D. Assimakopoulos ◽  
M. Karakitsou ◽  
K. Proikas ◽  
M. Tzagaroulakis
Keyword(s):  
Otitis Externa ◽  
Malignant Otitis Externa

The Development of Intelligence Walking Stick for Elderly Health Care using IoT

2020 ◽  
Vol 9 (5) ◽  
pp. 1334-1338
Keyword(s):  
Health Care ◽  
Daily Living ◽  
The Elderly ◽  
Mean Value ◽  
Real Time System ◽  
Pressure Oxygen ◽  
Elderly Health ◽  
The Mean ◽  
Iot Devices ◽  
Walking Stick

Nowadays, Thailand is stepping into an aging society. This research purposes developing the intelligence walking stick for the elderly in terms of the health care system by applied the IoT devices and biometric sensors in a real-time system. The heart rate, blood pressure, oxygen saturation, and temperature were measured at the finger of the elderly that holding the intelligence walking stick. All data can monitor and display on mobile devices. The intelligence walking stick system was evaluated by twenty users who are five experts and fifteen elderly in Ratchaburi province. As a result of the mean value at 4.88 and 4.85 by experts and elderly, respectively. It could be said that the development of intelligence walking stick by using IoT can help and improve the daily living of the elderly at the highest level.

Effect of Surgical Versus Pharmacological Decompression of Ludwig’s Angina on Airway Compromise among Nigerian Patients

2020 ◽  
Author(s):  
Ekaniyere EB
Keyword(s):  
Length Of Hospital Stay ◽  
Surgical Decompression ◽  
Airway Compromise ◽  
Inclusion Criteria ◽  
Hospital Stays ◽  
Ludwig’S Angina ◽  
The Mean ◽  
The University ◽  
Ludwig's Angina ◽  
Gender Type

Background: Even though the decompression of the cellulitis phase of Ludwig’s angina (LA) by surgical or pharmacological approach is well documented, it is unclear which approach is more effective. Objective: We aim to compare the outcome of treatment between surgical versus pharmacological decompression in patients with LA. Subjects and Methods: A retrospective cohort study was designed. Data were collected from the case notes of patients that met the inclusion criteria from 2004 to 2018 at the University of Benin Teaching Hospital, Nigeria.The data were age, gender, type of decompression approach, length of hospital stay (LOS) and airway compromise. Result: A total of 62 patients comprising 37(59.7%) surgical decompression group and 25(40.3%) pharmacological decompression group were studied. Thirty-six (58.1%) males and 26 (41.9%) females were studied. Their mean age and standard deviation were 40.6 years and 11.9 years respectively. The mean length of hospital stays between the pharmacological and surgical decompression groups were 8.05 days and 13.8 days respectively. The incidence of airway compromise in the surgical decompression group was 19.9% lower than that of the pharmacological decompression group (P=0.47), which was not significant. The type of decompression approach also failed to influence the incidence of airway compromise (P = 0.41). Conclusion: The use of surgical versus pharmacological decompression does not significantly alter the incidence of airway compromise in the management of LA. The Patients that had surgical decompression had a shorter stay in the hospital as compared to those who had pharmacological decompression. This was not statistically significant.

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