Malignant otitis externa: Difference between revisions
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==Disposition== | ==Disposition== | ||
*Contact ENT for disposition decision; early infection may be managed as outpt | |||
==Complications== | ==Complications== |
Revision as of 22:13, 1 March 2015
Background
- Life-threatening infection of external ear/canal, soft tissue, +/- spread to skull base
- Diabetes and immunosuppression are main risk factors
- Pseudomonas causes >90% of cases
- Begins as simple otitis externa
Clinical Features
Adults
- Otitis externa that has not resolved despite 2-3wks of topical antibiotics
- Otalgia
- Often out of proportion for routine otitis externa
- Edema of external auditory canal
- Granulation tissue often seen in the ear canal floor
- CN IX, X, or XI involvement
- Trismus
Pediatrics
- More rapidly progressive than in adults
- TM, middle ear, and facial nerve more likely to be affected
Differential Diagnosis
Ear Diagnoses
External
- Auricular hematoma
- Auricular perichondritis
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
Internal
- Acute otitis media
- Chronic otitis media
- Mastoiditis
Inner/vestibular
Diagnosis
- CT
Treatment
Adults
Peds
Disposition
- Contact ENT for disposition decision; early infection may be managed as outpt
Complications
- Lateral or sigmoid sinus thrombosis
- Meningitis
See Also
Source
- Tintinalli