Introduction
Basics
- Uncommon type of otitis externa that is found in immunocompromised individuals (90% cases found in diabetics)
- Infective organism is usually Pseudomonas aeruginosa
- Infection commences 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
Clinical features
Key features in history
- Diabetes (90%) or immunosuppression (illness or treatment related)
- Severe, unrelenting, deep-seated otalgia
- Temporal headaches
- Purulent otorrhea
- Possibly dysphagia, hoarseness, and/or facial nerve dysfunction
Investigations
Diagnosis
- A CT scan is typically done
Management
Treatment
- Intravenous antibiotics that cover pseudomonal infections