Malignant (necrotizing) externa otitis: the experience of a single hyperbaric centre

Amaro, Carla; Espiney, Raquel; Radu, Lucian; Guerreiro, Francisco

doi:10.1007/s00405-019-05396-7

Cited by 24 publications

(38 citation statements)

References 20 publications

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“…MEO is an invasive and potentially fatal condition [ 2 ]. It is characterized by challenging management because of the need for long-term therapy requiring regular monitoring [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…This pathology affects commonly elderly patients with diabetes and impaired immune systems [ 1 , 2 , 5 ]. In most cases, MEO is caused by Pseudomonas aeruginosa ; Staphylococcus epidermidis , Proteus mirabilis , and fungal infections also have been implicated [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…When the index of clinical suspicion is high for MEO, computed tomography (CT) and magnetic resonance imaging (MRI) facilitate diagnosis and evaluation of disease progression [ 2 ]. To prevent recurrence after patient’s symptoms have improved, radionuclide scans, such as with Gallium – 67 – citrate ( 67 Ga) or 111 Indium ( 111 In), can be performed to identify areas of active residual infection [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…To prevent recurrence after patient’s symptoms have improved, radionuclide scans, such as with Gallium – 67 – citrate ( 67 Ga) or 111 Indium ( 111 In), can be performed to identify areas of active residual infection [ 8 ]. Treatment includes antibiotics (third-generation cephalosporins and fluoroquinolones such as ciprofloxacin) [ 1 , 9 ], local antibiotic washing of the external auditory canal, and finally surgery [ 2 ]. Some patients don’t respond to this treatment because of fungal infection (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Malignant Otitis External: Our Experience and Literature Review

et al. 2020

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Case series Patients: Male, 74-year-old • Male, 76-year-old • Male, 77-year-old Final Diagnosis: Malignant otitis externa Symptoms: Edema • facial paralysis • hearing loss • otalgia and major otorrhea in the right ear Medication: — Clinical Procedure: ENT examination Specialty: Otolaryngology Objective: Unusual clinical course Background: Malignant external otitis (MEO) is an invasive infection that can involve the external auditory canal and the skull base up to the contiguous soft tissues. Considering the changing face of MEO, we reviewed cases of MEO treated in our Ear Nose Throat (ENT) clinic – University Federico II of Naples between 2018 and 2019 to evaluate the current epidemiology of the condition and to assess the state of art on diagnosis, therapeutic and follow-up management in our patients. Case Reports: We present the cases of three male patients with Type 2 diabetes mellitus who complained of long-lasting otorrhea and pain, with clinical suspicion of MEO. In all cases, ear swab was positive for Pseudomonas aeruginosa . All our patients received a 6-week course of intravenous ciprofloxacin, piperacillin, and tazobactam, with rapid clinical symptoms improvement and complete recovery at 1-year follow-up. Conclusions: MEO is difficult to treat due to the lack of standardized care guidelines. Patients with MEO often present with severe otalgia, edema, otorrhea, and facial nerve paralysis. Clinicians must suspect MEO in elderly diabetic and immunocompromised patients with persistent otalgia after external otitis. Imaging (computed tomography and magnetic resonance imaging) can play synergistic roles in the management of MEO. To evaluate eradication of the disease, clinicians have to assess clinical symptoms and signs as well as radiological imaging and inflammatory markers.

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“…MEO is an invasive and potentially fatal condition [ 2 ]. It is characterized by challenging management because of the need for long-term therapy requiring regular monitoring [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Malignant Otitis External: Our Experience and Literature Review

et al. 2020

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“…This enhances the penetration of antimicrobial agent and phagocytic activity of macrophages, neovascularization and enhances wound healing. 32,33 In using HBOT with antimicrobials, we could treat clival osteomyelitis successfully with recovery of IX and XII cranial nerve weakness.…”

Section: Discussionmentioning

confidence: 99%

Lemierre’s disease: a typical presentation in two diabetic patients

Kalbani

Singh

Sheibani

2020

Int J Otorhinolaryngol Head Neck Surg

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Lemierre disease (LD) is a rare but potentially life-threatening condition, characterized internal jugular vein suppurative thrombophlebitis and disseminated septic emboli following a recent oropharyngeal infection. It is seen commonly in healthy young adolescents or adults, caused by gram negative anerobic Fusoform necropharum. Lack of awareness of this condition delays treatment and worsens prognosis. We present two interesting cases of LD in diabetic patients, caused by Klebsiella pneumonia and Haemophilus influenza organisms at our hospital. Both patients had atypical presentations. Diagnosis of such atypical cases poses diagnostic and therapeutic challenges.

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