malignant otitis externa
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Etiology
- Pseudomonas aeruginosa (most common)
- Aspergillus fumigatus
- Candida glabrata
Clinical manifestations
- fever > 39 C
- disproportionate pain, severe, persistent otalgia
- ear discharge, temporomandibular pain, & headache
- swelling & edema of the auditory canal
- granulation tissue along with purulent drainage
- external ear structures may also be swollen & tender
Laboratory
Radiology
- CT of the temporal bones with & without contrast may show bony erosions
Complications
- osteomyelitis
- mastoiditis
- infection of temporal bone
- invasion of cranial nerves
Management
- hospitalization
- broad-spectrum antibiotics with pseudomonal coverage
- urgent referral to otolarygologist
- intravenous antibiotics (active against pseudomonas)[1]
- also see otitis externa
More general terms
References
- ↑ 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 16, 18 American College of Physicians, Philadelphia 2012, 2018.
Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025 - ↑ Long DA, Koyfman A, Long B. An emergency medicine-focused review of malignant otitis externa. Am J Emerg Med. 2020 Aug;38(8):1671-1678. PMID: https://pubmed.ncbi.nlm.nih.gov/32505469 Review.
- ↑ Karaman E, Yilmaz M, Ibrahimov M, Haciyev Y, Enver O. Malignant otitis externa. J Craniofac Surg. 2012 Nov;23(6):1748-51. PMID: https://pubmed.ncbi.nlm.nih.gov/23147298