Sphenoidal sinusitis secondary to malignant external otitis

Youngs, Robin; Bagley, John

doi:10.1017/s0022215100099254

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…Finally, the infection can also propagate along the vascular channels (lateral sinuses, inferior and superior petrosal sinuses) and the bone surfaces of the pyramid, both towards the posterior fossa and middle fossa as far as the petrous apex. Infection may then spread by way of the clivus to the sphenoid sinus (39), and then to the contralateral temporal bone. The pneumatized zones of the temporal bone, the otic capsule and the membranous labyrinth are generally spared (3, 40,41).…”

Section: Evolution and Complicationsmentioning

confidence: 99%

“…In particular, ceftazidime is a third-generation, / 3 -1actamase resistant cephalosporin, bactericidal for Pseudonzonas and other Gram-negative germs (54). At a dosage of 2 g every 8 hours it has proved effective in controlling many cases of MEO-both when administered alone (54,55) and in association with tobramycin ( 16)even after failure of the association of aminoglycoside plus fl-lactamase (39). However, this form of treatment also has its disadvantages since it requires intravenous administration for a prolonged period of time, and thus lengthy hospital care (54).…”

Section: Therapeutic Problemsmentioning

confidence: 99%

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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: Evolution and Complicationsmentioning

confidence: 99%

Section: Therapeutic Problemsmentioning

confidence: 99%

Malignant External Otitis: Review and Personal Experience

Amorosa

Modugno

Pirodda

1996

Acta Oto-Laryngologica

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“…Other cranial nerve palsies secondary to the skull base osteomyelitis, have an incidence of 14 to 35 per cent (Rubin and Yu, 1988). Isolated reports of other complications include brain abscess (Soliman, 1978), sphenoidal sinusitis (Youngs and Bagley, 1986), mycotic aneurysm (Watson, 1977), parotitis (Caruso et al, 1977), and venous sinus thrombosis (Evans and Richards, 1973;Chandler, 1974).…”

Section: Introductionmentioning

confidence: 99%

Malignant otitis externa in HIV and AIDS

et al. 1996

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Malignant otitis externa is a necrotising infection of the external ear canal which may spread to include the mastoid and petrous parts of the temporal bone, leading to skull base osteomyelitis. It is almost exclusively caused by infection with Pseudomonas aeruginosa, and usually occurs in elderly non-insulin-dependent diabetic patients. However isolated cases have been reported in a small number of non-diabetic patients, particularly in children who are immunocompromised due to malignancy, malnutrition and severe anaemia. In 1984 a case of malignant otitis externa was reported in a child with an acquired immunodeficiency syndrome (AIDS)-like illness, prior to identification of the human immunodeficiency virus (HIV). Since that time further sporadic cases of this invasive infection have been reported in HIV and AIDS. We present two further cases and also a review of the current literature.

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“…If, however, collections of fluid or necrotic debris are identified by radiologic studies, surgical removal of infected materials becomes important for cure 10 . Of those cases with bilateral cranial nerve involvement, there has been an associated mortality rate of 60% 11 . These cases demand surgical and medical management, with surgery usually involving radical mastoidectomy.…”

Section: Discussionmentioning

confidence: 99%

Acute Pseudomonas Infection of the External Ear (Malignant External Otitis)

Scherbenske

Winton²,

James³

1988

The Journal of Dermatologic Surgery and Oncology

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Pseudomonas aeruginosa commonly causes low-grade infections of the external auditory canal. If these infections are inadequately treated, they can progress into a severe form of external otitis called malignant external otitis (MEO). MEO usually occurs in elderly diabetic patients and demands immediate diagnosis and medical therapy in order to prevent systemic invasion, neurologic sequelae, and even death. We present two cases of acute pseudomonas infections of the ear, neither of which progressed to MEO due to early implementation of antibiotic therapy.

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Sphenoidal sinusitis secondary to malignant external otitis

Cited by 11 publications

References 5 publications

Malignant External Otitis: Review and Personal Experience

Malignant External Otitis: Review and Personal Experience

Malignant otitis externa in HIV and AIDS

Acute Pseudomonas Infection of the External Ear (Malignant External Otitis)

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