Malignant external otitis in infants

Cóser, Pedro Luiz; Stamm, Aldo Eden Cassol; Lobo, Ruy Carlos; Pinto, José Antônio

doi:10.1288/00005537-198002000-00017

Cited by 43 publications

(15 citation statements)

References 9 publications

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“…1,2 Since Chandler's publication of the first comprehensive case series of MEO in 1968, 1 the most commonly reported causative pathogen has been Pseudomonas aeruginosa (>98% of cases). 3 Other pathogens include Staphylococcus aureus, 4 Staphylococcus epidermidis, 5 Proteus mirabilis, 6 and Klebsiella oxytoca. 7 Fungi are rarely involved in MEO, and have been identified particularly in immune-compromised nondiabetic patients, such as patients with AIDS or acute leukemia.…”

Section: Introductionmentioning

confidence: 99%

Fungal malignant external otitis

Hamzany

Soudry

Preis

et al. 2011

Journal of Infection

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Section: Introductionmentioning

confidence: 99%

Fungal malignant external otitis

Hamzany

Soudry

Preis

et al. 2011

Journal of Infection

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“…Other bacterial organisms that have also been associated areStaphylococcus aureus [17,18], especially MRSA, Staphylococci epidermidis [19], Proteus mirabilis and Klebsiella oxytoca [20,21]. Pseudomonas aeuruginosa is an obligate gram negative aerobe that tends to colonize in a moist external auditory canal especially in indivisuals with impaired immunity; whereas Staphylococci, Proteus and Klebsiella are not true pathogens but commensals.…”

Section: Etiopathogenesismentioning

confidence: 99%

Malignant Otitis Externa-A Review

S¹

2014

J Infect Dis Ther

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Objective: To review the literature about Malignant Otitis Externa. Methodology:A comprehensive review of existing knowledge that is available in literature has been summarised in this article.Results: There is a rising incidence of Malignant Otitis Externa in the developing countries, predominantly seen in elderly diabetics. The common organism isolated is Pseudomonas aeruginosa though other microbials have been described as a causative agent. Radioimaging such as Technitium 99m MDP Scintigraphy, Gallium 67 Single Photon Emission CT and Tc99m Sulesomab scan has been recently used to asses and monitor therapy. The treatment protocol involves initial management with intravenous antimicrobials, regular aural toileting with adjunctive Hyperbaric Oxygen therapy. Unresponsive patients require either a trial with antifungals or a tissue diagnosis to rule out other differentials. Surgery is no longer found to be a first line treatment of MOE. Conclusion:Malignant Otitis Externa is a highly fatal, necrotizing condition of the external auditory canal and temporal bone which is seen in elderly immunocompromised individuals. It is a highly aggressive skull base infection that is associated with high morbidity/mortality and cranial nerve complications. Although a variety of organisms such as Proteus mirabilis, Staphylococci, Klebsiella species and Aspergillus fumigatus have been implicated in the pathogenesis of MOE, Pseudomonas aeruginosa has been a predominant organism closely associated with MOE. With the advent of present day radiological imaging and effective antimicrobials coupled with a high index of suspicion, the mortality rate has been reduced from an alarming 50% to 20% over the past few decades.

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“…All but two occurred in immunocompromised patients. In one case, infection was due to Staphylococcus epidermidis [3], in three cases [2,4,12] to Staphylococcus aureus, in four cases to Aspergillus fumigatus [7] or A. flavus [9], and in one case to Proteus mirabilis [6]. Staph.…”

Section: Introductionmentioning

confidence: 97%

Necrotizing otitis externa caused by Staphylococcus epidermidis

Soldati

Mudry

Monnier

1999

European Archives of Oto-Rhino-Laryngology

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We present a case of malignant necrotizing otitis externa (MNOE) caused by Staphylococcus epidermidis, which is usually a non-pathogenic microorganism. The patient is an otherwise healthy, nondiabetic 58-year-old white man. Contributory history began in 1994 after surgery for bilateral exostoses of the external auditory canals. Between April 1994 and May 1998 persistent otalgia occurred, with progressive mixed hearing losses, purulent discharge from both ears, spontaneous perforations of the tympanic membranes and ulceration of canal wall skin. From the beginning, Staph. epidermidis was isolated in all but one culture, but was not recognized as the pathological agent because of the presence of other more frequently involved bacteria and fungi. After multiple intravenous and oral antibiotics and antifungal treatments failed, further management involved frequent debridement of both external auditory canals and tympanic membranes, right tympanoplasty, bilateral mastoidectomy, revision tympanomastoidectomies and left modified radical mastoidectomy. Antistaphylococcal therapy including ceftazidime, vancomycin, teicoplanin, clindamycin and rifampicin was tried. Following the modified radical radical mastoidectomy, normalization of the status of his ears took approximately 2 months and has since remained stable to date. His left ear is deaf because of vancomycin administration, while magnetic resonance imaging and gallium scintigraphy have shown persistent inflammation of the skull base.

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Malignant external otitis in infants

Cited by 43 publications

References 9 publications

Fungal malignant external otitis

Fungal malignant external otitis

Malignant Otitis Externa-A Review

Necrotizing otitis externa caused by Staphylococcus epidermidis

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