Malignant otitis externa

Question 1

what is it

Answer 1

Uncommon type of otitis externa that is found in immunocompromised individuals

Question 2

cause

Answer 2

Pseudomonas aeruginosa

Question 3

where does infection commence and progress

Answer 3

in the soft tissues of the external auditory meatus, then progresses to involve the soft tissues and into the bony ear canal

Progresses to temporal bone osteomyelitis

Question 4

associated conditions

Answer 4

diabetes

immunosuppression

Question 5

features

Answer 5

Severe, unrelenting, deep-seated otalgia
Temporal headaches
Purulent otorrhea
Possibly dysphagia, hoarseness, and/or facial nerve dysfunction

Question 6

Ix

Answer 6

A CT scan is typically done

Question 7

Mx

Answer 7

non-resolving otitis externa with worsening pain should be referred urgently to ENT

Intravenous antibiotics that cover pseudomonal infections