title: Necrotizing otitis externa: a painless reminder.
abstract: Necrotizing otitis externa is a necrotizing osteomyelitis of the skull base that predominantly affects diabetic and immunocompromised patients. Pseudomonas aeruginosa is the most frequently implicated organism. Patients present with severe otalgia, otorrhoea with or without facial palsy, or rarely, facial pain as a symptomatic feature. We report a case of necrotizing otitis externa presenting with totally painless otorrhoea and highlight the need for a high index of suspicion when treating patients with otitis externa.
authors.affiliation: Department of Otolaryngology, Royal Berkshire Hospital, Reading RG1 5AN, UK. daniel.thio@yahoo.co.uk
authors.forename: Daniel
authors.initials: D
authors.lastname: Thio
authors.forename: Phillip
authors.initials: P
authors.lastname: Reece
authors.forename: Rory
authors.initials: R
authors.lastname: Herdman
mesh_terms: D001284:Atrophy; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D010032:Otitis Externa / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D010579:Petrous Bone / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D019291:Skull Base / Q000473:pathology