title: Malignant otitis externa in a healthy non-diabetic patient.
abstract: A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function. Computed tomography (CT) and magnetic resonance imaging (MRI) studies at our hospital showed osteomyelitis involving the left temporal, occipital, and sphenoid bones, the mandible, and an epidural abscess. Routine blood testing and tests of immune function were normal, and no evidence of other infectious processes was found. He was diagnosed with malignant otitis externa (MOE). Bone debridement and incision and drainage of the epidural abscess were performed, and vancomycin was administered because culture results revealed Corynebacterium jeikeium, Corynebacterium xerosis, and Enterococcus faecalis. MOE should be considered in healthy patients with external otitis who fail initial treatment.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China. lxldxx2007@126.com.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Mo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China. yliang_2006@126.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liang
mesh_terms: D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage / Q000379:methods; D004427:Ear Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005402:Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D010032:Otitis Externa / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D010035:Otitis Media, Suppurative / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013701:Temporal Bone / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents
keywords: Diabetes; Immunocompromised; Malignant otitis externa; Osteomyelitis