Malignant external otitis: treatment with prolonged usage of antibiotics and Burow's solution.
Malignant external otitis is a severe infection of the external auditory canal, generally caused by Pseudomonas aeruginosa in elderly diabetics patients. We describe a case of malignant external otitis in a 63-year-old man with severe otalgia, purulent otorrhea and polypoid granulation of the external auditory canal. Local debridement, insulin treatment and 6-week intravenous antibiotic therapy with carbapemens were very effective and the granulation tissue disappeared completely. However, the patient readmitted for recurrent disease 3 weeks later, despite the oral and ear drop administration with new quinolone. No recurrence has been noted after 4-week additional treatment with intravenous carbapenems followed by 3-week treatment with Burow's solution as ear drops.
Shimizu
Takeshi
T
Department of Otorhinolaryngology, Shiga University of Medical Science and Mie University School of Medicine, Tsukinowa, Seta, Otsu, Shiga 520-2192, Japan. shimizu@belle.shiga-med.ac.jp
Ishinaga
Hajime
H
Seno
Satoshi
S
Majima
Yuichi
Y
D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use*; D000287:Administration, Topical; D015780:Carbapenems / Q000008:administration & dosage / Q000627:therapeutic use*; D003646:Debridement; D004359:Drug Therapy, Combination; D004431:Ear, External / Q000000981:diagnostic imaging / Q000382:microbiology; D006097:Granulation Tissue; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000382:microbiology; D011552:Pseudomonas Infections / Q000150:complications* / Q000628:therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013704:Temporomandibular Joint / Q000382:microbiology / Q000473:pathology; D014057:Tomography, X-Ray Computed
D000085:Acetates; D015780:Carbapenems; D007328:Insulin; C013396:aluminum acetate