Ear Nose Throat J. 1994 Oct;73(10):772-4, 777-8. Unique Identifier :
Malignant otitis externa is a necrotizing infection of the external ear
canal and surrounding soft tissue and bone, usually caused by
Pseudomonas aeruginosa. The infection classically occurs in diabetic
patients, however recently, several patients with the acquired
immunodeficiency syndrome (AIDS) have been reported to have malignant
otitis externa. A patient with AIDS who had malignant otitis externa
with skull base osteomyelitis is presented and reported cases in
patients with AIDS are reviewed. Predisposing factors include
immunologic abnormalities (notably neutropenia), dermatitis,
medications, neoplasm, and iatrogenic procedures, e.g., ear lavage.
Treatment of malignant otitis externa has traditionally included
anti-pseudomonal cephalosporins/penicillins and aminoglycosides for
prolonged durations. Recently, ciprofloxacin has been shown to be
effective as an oral regimen. With the increasing number of patients
with AIDS being seen in the outpatient clinics, the diagnosis of
malignant otitis externa should be considered in any patient with
persistent ear pain or otorrhea who does not respond to conventional
treatment for external otitis.
Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult
Antibiotics/THERAPEUTIC USE Bone Diseases/PATHOLOGY Case Report
Ciprofloxacin/ADMINISTRATION & DOSAGE/THERAPEUTIC USE Human Male
Otitis Externa/*COMPLICATIONS/DRUG THERAPY/*MICROBIOLOGY Pseudomonas
aeruginosa/*ISOLATION & PURIF Skull/PATHOLOGY JOURNAL ARTICLE