Complicated necrotizing otitis externa.
Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications.
University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Electronic address: mtn2m9@mail.umkc.edu.
Mariam T
MT
Nawas
Vistasp J
VJ
Daruwalla
David
D
Spirer
Alan G
AG
Micco
Alexander J
AJ
Nemeth
D000038:Abscess / Q000209:etiology*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D048909:Diabetes Complications; D004487:Edema / Q000000981:diagnostic imaging; D005158:Facial Paralysis / Q000209:etiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008417:Mastoiditis / Q000150:complications*; D010019:Osteomyelitis / Q000150:complications / Q000188:drug therapy; D010032:Otitis Externa / Q000150:complications* / Q000000981:diagnostic imaging; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012851:Sinus Thrombosis, Intracranial / Q000150:complications*; D013701:Temporal Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000601:surgery
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin