Malignant external otitis versus acute external otitis

Cohen, David J.; Friedman, Peter C.; Eilon, Amos

doi:10.1017/s0022215100101550

Cited by 19 publications

(6 citation statements)

References 7 publications

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“…By now it must have become clear to the reader that there is a fair amount of nosological uncertainty, and as a result some confusion in terminology: the interpretative difficulties particularly concern less severe forms of MEO, without complications and with untypical features, where a clear-cut distinction from non-malignant external otitis is not always easy to make. Furthermore, this consideration reflects the uncertainty surrounding the pathogenesis of MEO: whether it should be thought of as a distinct entity ah initio from non-malignant external otitis, or whether the two forms represent different evolutions of a single initial disease (14). Differential diagnosis between the malignant and non-malignant variety, however, would be very useful at an early stage, as this permits selection of the most appropriate type and length of treatment, and thus determines not only the Malianant external otitis costs to the patient and health service (11,14), but above all the prognosis, which in M E 0 is related to timely therapeutic intervention ( 15).…”

Section: Review O F the Literaturementioning

confidence: 99%

Malignant External Otitis: Review and Personal Experience

Amorosa

Modugno

Pirodda

1996

Acta Oto-Laryngologica

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Amorosa L, Modugno GC, Pirodda A. Malignant externul otitis: review and personul experience. Acta Otolaryngol (Stockh) 1996; Suppl 521: 1-14,Malignant external otitis (MEO) is an infrequent but severe infective disorder, generally due to Pseudomonas ueruginosu, which most often affects elderly diabetics patients. The clinical features rarely permit exact diagnosis of M E 0 to be made promptly, and initially at least they are difficult to distinguish from those of external otitis. This explains the frequent delay in diagnosis with respect to the onset of symptoms. Physical examination almost always reveals the presence of aspecific granulation tissue in the external auditory canal, while the most common laboratory finding is raised erythrocyte sedimentation rate (ESR). Imaging has great diagnostic relevance: C T and MRI are very useful for spatial resolution, while radionuelide scanning and, in our experience, SPECT are superior for detecting early osteitis and monitoring response to therapy. We present an extensive review of the literature and our personal experience. In particular, we stress the relevance of immunological study of M E 0 patients: all our 4 patients had defective immune defences. As regards therapy. like other authors we underline the fundamental importance of long-term antibiotic treatment. The availability of quinolones and latest generation cephalosporins has greatly simplified the choice of antibiotic treatment, although clinicians should be aware of the possibility of drug-resistant bacterial strains.

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Section: Review O F the Literaturementioning

confidence: 99%

Malignant External Otitis: Review and Personal Experience

Amorosa

Modugno

Pirodda

1996

Acta Oto-Laryngologica

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“…Shamboul and Burns Cohen et al 1959Cohen et al 1968Cohen et al 1971Cohen et al 1972Cohen et al 1972Cohen et al 1975Cohen et al 1976Cohen et al 1976Cohen et al 1976Cohen et al 1977Cohen et al 1977Cohen et al 1978Cohen et al 1978Cohen et al 1978Cohen et al 1980Cohen et al 1981Cohen et al 1981Cohen et al 1982Cohen et al 1982Cohen et al 1982Cohen et al 1982Cohen et al 1982Cohen et al 1983Cohen et al 1983Cohen et al 1985 No. of Cases Reported treated surgically it was always found.…”

Section: Ichimuramentioning

confidence: 99%

The diagnostic criteria of malignant external otitis

Cohen¹,

Friedman²

1987

J. Laryngol. Otol.

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134

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“…Necrotizing external otitis is currently thought to represent a spectrum of disease, with invasion of soft tissues early in the process and bone involvement as the disease progresses 3‐5 . The ability to recognize this disease in its very early stages has led to difficulty in differentiating early NEO from severe acute otitis externa in some cases 4‐6 …”

Section: Introductionmentioning

confidence: 99%

“…Classically, NEO has been considered a disease of elderly diabetic patients 1‐5 . However, several reports of NEO in patients without diabetes have been documented 2,7‐13 .…”

Section: Introductionmentioning

confidence: 99%

Necrotizing External Otitis in Patients with AIDS

et al. 1997

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In a retrospective review of seven patients with AIDS who were diagnosed with necrotizing external otitis between 1990 and 1995, it was found that the presentation of necrotizing external otitis in patients with AIDS differed from the classic description of malignant external otitis in several respects. The patient population was significantly younger and nondiabetic. Granulation tissue was usually absent from the external auditory canal and Pseudomonas aeruginosa was not the predominant pathologic organism. Also, outcome was found to be significantly worse. Thus a high index of suspicion must be entertained and vigorous local and systemic treatment initiated early in the course of disease to achieve a satisfactory outcome.

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Malignant external otitis versus acute external otitis

Abstract: Malignant External Otitis (MEO) and Acute External Otitis (AEO) are clinically very similar in their beginnings. It is important to differentiate between them very early. Bone scanning is the best diagnostic tool. Eight cases of AEO and MEO are herewith presented.

Cited by 19 publications

References 7 publications

Malignant External Otitis: Review and Personal Experience

Malignant External Otitis: Review and Personal Experience

The diagnostic criteria of malignant external otitis

Necrotizing External Otitis in Patients with AIDS

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