Malignant otitis externa: case series.
BACKGROUND
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.


METHODS
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.
Ali
T
T
Department of Radiology, Freeman Hospital, Newcastle upon Tyne, UK.
Meade
K
K
Anari
S
S
ElBadawey
M R
MR
Zammit-Maempel
I
I
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003389:Cranial Nerve Diseases / Q000453:epidemiology* / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D004433:Earache / Q000209:etiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010032:Otitis Externa / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology; D011550:Pseudomonas aeruginosa; D012008:Recurrence; D012189:Retrospective Studies; D013845:Thienamycins / Q000627:therapeutic use
D000890:Anti-Infective Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D000077731:Meropenem